Lip fillers 4 years ago. I haven't gotten any more. My smile has changed. One side shows more teeth. Can it be fixed? (Photo)

Hi there,

Thank you for sharing your story and photo — it’s completely understandable to feel concerned about subtle changes in your smile and lip symmetry, especially after having had fillers in the past. You’re right that several factors can contribute, including the natural aging process, past filler placement, and even small differences in muscle movement on each side of the face.

Here’s what may be happening:
With time, our facial fat pads and collagen levels decrease, and one side of the face often loses a bit more volume than the other — something that becomes more noticeable in our 40s and 50s. Previous filler treatments can also affect how tissue settles or how the smile moves, especially if the filler was placed unevenly or took a while to dissolve completely.

There are ways to improve balance:

Small corrective filler touch-ups can restore evenness and subtly lift the area that sags more.

Botulinum toxin (Botox/Dysport) can help balance the muscle pull that lifts one side higher.

Energy-based treatments such as radiofrequency or ultrasound tightening can improve firmness and lip contour.

Lip exercises and skincare with hydrating or plumping ingredients can help maintain volume naturally.

What you’re noticing is very common and absolutely treatable — your smile can be balanced while still looking natural.

We see more and more patients with history of multiple injections of lip fillers presenting with secondary, acquired deformities. This is usually related to scar formation, displacement of filler, etc. correction of these deformities may include multiple modalities including surgeries. Hope this helps.

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. A lip lift is capable of correcting asymmetry in the position of the lateral lips. You may benefit from a lip lift.

Best Wishes,

Gary Horndeski, M.D.