I have lip asymmetry - more like an indent (top right lip) (Photo)

I am unclear about my options. Financing is no longer a concern and I am very ready to get this fixed. Please note, in this image my lips & face are completely relaxed, and light is directly pointed towards my face. The indent appears like this in daylight as well . It's always showing, unless I'm smiling. Option ideas: hydraulic acid injections, implants, fat grafting? The more permanent the better, no? However fat grafting's possible negative side effects concern me. Thank you RealSelf.

Doctor Answers 6

Lip augmentation

I like hyaluronic acid (juvederm ultra XC) for lip augmentation; I do not think it is better to do permanent first. I would try the juvederm first, and it will last 9-12 months. It should correct the indentation you are concerned about. Please consult a board certified dermatologist or plastic surgeon for optimal results. Best, Anita Gill MD


The Woodlands Dermatologic Surgeon
5.0 out of 5 stars 4 reviews

Fat Grafting or Injections

Thank you for your question, aim4perfection. Your options include the temporary procedures with fillers and the more permanent solutions with fat grafting injection. I suggest you consult with a board certified facial plastic surgeon to ensure you receive the highest quality knowledge, treatment, care and skill available.

Best wishes,

Ross A. Clevens, MD
Melbourne Facial Plastic Surgeon
4.7 out of 5 stars 95 reviews

Hyaluronic Acid Volumizers Can Help Improve Lip Asymmetries

Thank you for your photograph. I clearly see the indentation you describe in the right portion of your upper lip. From its appearance, it looks as though it would be easily amenable to improvement via the injection of a volumizing filler, such as Juvederm Ultra Plus XC, which I would use in my Upper East Side Manhattan practice or Princess Volume (my choice in my Israel satellite facility, where a far greater number of regulatory agency approved injectable volumizers are available). Hyaluronic acid fillers are natural and subject to the body's own natural metabolic, enzymatic processes, which I feel make them preferable to permanent fillers, which are entirely foreign to the body and have been associated with long-lasting, if not permanent problems, such as nodules and granulomas, which are difficult to treat.  Radiesse, a semipermanent calcium-based filler is also not recommended for this region due to possible nodule formation. 

Finally, I share your reservations regarding the use of fat grafting. In fact, I stopped performing it for any purpose over twenty years ago.

I strongly suggest you seek consultation and treatment by a board certified aesthetic physician with experience and training in lip augmentation, and not a practitioner accustomed and trained only to treat smile lines with ordinary fillers. Best of luck.



Nelson Lee Novick, MD
New York Dermatologic Surgeon
4.8 out of 5 stars 23 reviews

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Lip asymetry

I suggest you first consider the fillers that will not be permanent, that way you can see what the potential result could be.  I typically use Hyaluronic Acid products for the lips, either Juvederm or Belotero.  If you are pleased with these fillers, down the way you may consider a more longer lasting treatment, such as dermal or fat graft.

Samuel Shatkin, Jr., MD
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Lip Asymmetry

I have found it possible to fix almost all lip asymmetries with a filler.  Although you want a permanent solution, I have found that these "long lasting solutions" often bring their own problems and patients.  Best, Dr. Green

Lip Asymmetry

Your asymmetry is only apparent when you smile, so correction must be done with great care because your lips are quite attractive when in repose. I recommend correction with a filler like Juvederm Ultra plus by an experienced injector very conservatively because over correction will cause another asymmetry. If you like the result, then you can consider fat transfer for a longer lasting result. Seek out a board certified plastic surgeon or dermatologist with lots of experience treating lips. Good luck!

Robert M. Tornambe, MD
New York Plastic Surgeon
5.0 out of 5 stars 24 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.