Conservative
1. filler injections: Hyaluronic acid or other dermal fillers can be used to increase volume in the less full lip to improve symmetry.
2. lip surgery: In some cases, surgical correction may be considered to adjust the shape and volume of the lips.
3. make-up techniques: With skillful use of lipstick and contouring, you can create optical symmetry.
4. laser treatments: These can help to improve skin texture and refine the appearance of the lips.
5 Botox: In some cases, Botox can be used to relax the muscles around the lips and thus influence the shape.
It is important to seek advice from a specialist to find the best method for your individual needs
Surgical
1. scar correction & tissue redistribution
If the asymmetry is caused by scar tissue, scar revision can help. This involves removing the hardened tissue and resuturing the skin to achieve a more even shape of the lower lip. If necessary, tissue from neighboring regions can be used for reconstruction.
2. lip lift or lip plasty
If the corner of the lip is lowered or one side of the lip has less volume, a lip lift or lip augmentation (vermilion advancement) can be performed. This involves removing a small strip of skin to raise the corner of the lip or reshape the red of the lip.
3. muscle reconstruction (myoplasty)
If the damage also affects the muscles (e.g. due to an injury to the orbicularis oris muscle), it may be necessary to reconstruct the lip muscle. This involves moving or strengthening muscle fibers to achieve a more symmetrical movement and shape.
4. nerve surgery for paralysis (microsurgery)
If nerve damage (e.g. facial nerve or mental nerve) is the cause, microsurgical nerve reconstruction or nerve relocation may be useful. There are various techniques for this:
– Direct nerve suture, if the ends can still be connected.
– Nerve transplantation when a nerve is completely severed.
– Dynamic muscle transplantation if long-term paralysis is present (e.g. with muscle displacement from the thigh).
5. combined procedures with autologous fat grafting or implants
Sometimes the patient’s own fat or an implant is also used to compensate for volume loss or to improve symmetry.
Aftercare & healing
– Swelling and slight asymmetries may be normal in the first few weeks.
– Scar care is important to avoid hardening.
– If a nerve has been reconstructed, it may take months before an improvement is visible.
Asymmetry due to knots
If a scar lump below the corner of the mouth raises it unintentionally, there are several ways to correct it. The best method depends on how much the scar has distorted the tissue and whether there are any functional restrictions.
1. scar correction (surgical revision)
If the scar lump causes the tissue to contract, a surgical scar excision (removal of the scar) can be performed. The hardened scar tissue is removed and the wound is closed in such a way that the tension on the corner of the mouth is reduced. If necessary, a Z- or W-plasty procedure can be used to suture the skin in a more relaxed manner and prevent renewed contraction.
2. cortisone injections (for hardened scars)
If the scar is rather thickened and bulging (hypertrophic scar or keloid), cortisone injections can help to soften the tissue and reduce the tension on the corner of the mouth.
3. autologous fat or filler injections
If there is a volume deficit after the scar has been removed or the corner of the mouth remains slightly distorted, the patient’s own fat or a hyaluronic acid filler can be injected to even out the tissue and restore symmetry.
4. muscle or skin transplantation (for severe contractures)
If the scar is very tight and there are still problems after a simple scar correction, a local tissue shift or a small skin graft may be necessary to make the area softer and more mobile.
5. physiotherapy & massage
If the scar is still relatively fresh, a scar massage or stretching therapy can help to loosen the tissue and reduce the tension on the corner of the mouth.
Which method is right for you?
If the scar lump raises and restricts the corner of the mouth considerably, a surgical revision with possible tissue displacement would probably be the most effective solution. If the scar is only slightly indented, cortisone or massage may be sufficient.