Thank you for your question.
You submitted a question with one photo.
You say that every time you take a picture, your lip appears to be crooked.
And you want to know is this because of your jaw or because of lip muscles.
Well, I can certainly share with you how I evaluate patients who often have exactly the
same concern.
A little bit of background, I’m a Board-certified cosmetic surgeon and Fellowship-trained oculofacial
plastic and reconstructive surgeon.
I have been in practice in Manhattan and Long Island for over 20 years.
Helping people improve the appearance of their lips is something we do in our practice every
day.
So it is first very important for you to recognize that the human face is naturally asymmetric.
And the true basis for that asymmetry is the bone structure.
And so you’re kind of on the right track when you ask about the jaw.
I explain to my patients that we’re all beautifully imperfect and that there’s always
one side of the face where it is more projected compared to the other.
Now how does that help us in understanding in what to do for lips?
When we want to try to improve symmetry and we want to improve aesthetics, we have to
use some certain basic principles.
One of the basic principles is the Golden Ratio.
And as the Golden Ratio applies to lips, there’s a balance between the size and shape of the
upper lip compared to the lower lip.
So it’s often described as the one third to two thirds ratio or the one to one point
six ratio.
And very often, people who come to us and are concerned about their lips are incredibly
afraid of looking overdone thanks to the body dysmorphia of many celebrities who end up
overdoing their lips and looking unnatural.
So using those guidelines, you can consider possibly using a filler such as something
in the hyaluronic acid family to add volume to areas where there is a relative deficit
and at the same time, adding volume in a way to create an enhancement so that crooked appearance
doesn't look as obvious.
Now when it comes to the muscles around the lips, there is also opportunity.
We do something called a Botox® lip lift.
And the idea of the Botox® lip lift is by relaxing certain muscles and specifically,
this is the muscle called the depressor anguli oris muscle.
We can actually get the corners of the lips to come up a little bit.
So for someone who has asymmetry where one side of the corner of the mouth, the corner
is a little bit lower than the other.
If they’re both slightly upturned, it might create the illusion of more balance.
Further, not directly associated with the lip, is the chin.
And in the chin, there is a muscle called the mentalis muscle and that is responsible
for chin dimpling.
Well if we use Botox® to relax that muscle, well the lip can also get a little bit of
benefit from that.
As you can probably conclude is that there is a lot of nuance and a lot of art in doing
this.
And so I think it’s very important for you to find a physician who can develop these
ideas with you.
Examine you in a way that will provide you a three dimensional understanding of the anatomy
and of the interactions of the muscles and the way they interface and affect the lips.
And develop a strategy that I think ultimately will be of potential value.
I didn't further mention that you can also place fillers in different areas to help enhance
the lips indirectly.
So there is so much art to this and I think that point is well made.
So I hope that was helpful, I wish you the best of luck and thank you for your question.