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Manish H. Shah, MD answers: Facial asymmetry and paralysis after Botox

Is it normal for one side of my face to be larger or fatter than the other after Botox and with smile paralysis four months after the injections? That side feels very heavy when I smile as well. How long can the smile paralysis last? Will my face ever be symmetrical again?


Manish H. Shah, MD
5 months ago

I understand that your smile is important to your career so take what I say with a grain of salt.  Botox typically lasts only 3-4 months on initial injection. If Botox caused what you call "smile paralysis" then it should be gone by now. The pictures you submitted are all at an angle, making objective commentary impossible.

Your first picture already shows you with very thin lips to begin with. This did not change on the other pictures.  he only thing that I see is that you can't bring the corners of your mouth up quite as high as before the Botox. I can't comment on asymmetry because your pictures are at an angle.

You should go back to whatever level of symmetry or asymmetry you had before the Botox once its effects wear off. I would not focus on that area because the chances are that you are the only one that notices the difference. Also speak to a makeup expert as there may be a technique for makeup application that may camouflage your concerns temporarily until the Botox wears off.

Good Luck.

 

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