How to fix lip asymmetry & orange peel chin problem? (Photos)

Question

Hello, I am happy with my lip shape, and my upper lip length, but I have several problems in my mouth area: My lips are not symetric in the photos (left side hangs lower) I have a gummy smile (also not symetric: the left side lifts higher when I smile widely) My lips are naturally slightly open when relaxed (my teeth are not the smallest), and I got orange peel chin when closed. Can botox plus fillers help or there are other ways? Thanks (photos)

Jason Emer, MD · Answer

This is my expertise and a huge portion of my practice. Asymmetry is normal and expected. Buccal fat pad gives slimming not symmetry. Masseter botox will make you slimmer and make the jawline more loose. Fillers help give shaping and contouring. If you want perfect or close to perfect symmetry you need maxillofacial surgery or implants customized. I suggest seeing an expert to go through all options. Most of my younger clients use fillers to give them shaping especially on the cheeks, jawline, and chin which make the face look more slim and tight; and threads such as PDO or Instalift can build collagen and support the facial shaping and skin looseness over time, slowing down the aging process and given the face a more “snatched” look; and morpheus8 or PiXel8 deep microneedling RF can tighten crepe skin especially on the neck and jawline and is great for long term tightening of the full face, neck and chest; its often used to give the face a slimmer more sculpted look because it tightens the skin and gives lift. an early face lift can be performed as well even in younger clients if they want a different facial shape, maxillofacial surgery with bone breaking or shaving can also be done. For facial slimming a combination of treatments are always needed. Options include: 1. Buccal fat pad removal to reduce fat on the lower face 2. Factite or Renuvion/J Plasma to tighten the lower face, jawline, and chin to reduce fat and give the jawline and neck tightening and shaping. 3. Botox to the masseter to reduce the muscular size of the jaw giving the face an illusion of being more slender 4. Fillers to the jawline, chin, cheeks, temples and brow help to shape the face and make it more angled and defined Always use at home derma rolling (see link to Emerageskin x anteageMD roller plus stem cells/hyaluronic acid ampules) and peels like emeragecosmetics enlighten or aerify that can be used to improve skin quality and tighten the skin while improving wrinkles, pigmentation, acne, and Melasma. See an expert who does facial shaping with surgical and non surgical methods to get a comprehensive option. Best, Dr. Emer.

Gary M. Horndeski, MD · Answer

A lip lift does 4 things: shortens the distance between your nose and upper lip, increases the mucosa of the upper lip, increases the incisor show and pulls up the corners.

Best Wishes,

Gary Horndeski, M.D.

Nelson Lee Novick, MD · Answer

I have personally been using Botox for treating orange peel chins and gummy smiles for more than two decades. A few microdroplets of Botox in the appropriate locations in the chin and microdroplets placed properly to the areas lateral to the nasal wings can alleviate the peau d'orange of the chin and diminish the gummy smile, respectively. Just be sure that you consult with a board certified cosmetic dermatologist with experience and expertise in the use of Botox for these more advanced injection techniques. Best of luck.

Daniel Barrett, MD · Answer

Dear Good986472,
I perform a lot of lip injections with fillers such as juvederm and it works great. Many times I need to put more in one side than the other to attempt to even out the vermillion border (The red line of the lip). This helps provide more symmetry at times.For patients looking for a more long lasting result, I recommend fat grafting. That is, using your own bodies fat to make your lips naturally look more shapely. The bonus is that the results last many many years.
In general, I avoid using permanent prosthesis because I find that the lips are such dynamic and sensitive structures, the end result is not natural.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Camille Cash, MD · Answer

Botox and fillers can help address your concerns.  Botox can be used to help soften the dimpling of the chin.  It can also be used to improve a gummy smile.  Fillers can be used to help add volume and improve asymmetry of the lips.  The next step is to visit with an expert injector near you for treatment.

Darryl J. Blinski, MD · Answer

Yes a detailed combination of Botox to correct asymmetric "gummy smile" in 2 sessions. HA fillers also to upper lips in small dosing. diluted Botox to orange peel effected chin skin. Expect fees in the $3,000+ ranges.

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