I've had Bell's Palsy since childhood. I'm 47 now, and I had Botox injected in my forehead, the sides of my eyes, and in my chin for the dimple caused by Bell's Palsy. I also had it in the line between my cheeks and nose for the slight twitching. Two days later, my mouth drooped, and it looks like I've got Bell's Palsy again, although the plastic surgeon said it will be okay in a month. It's been two weeks now, why hasn't it gotten any better?
Its hard to know for sure, but the injection between your cheek and nose is probably the one responsible. It is likley affecting one of the muscles responsible for lifting the mouth.
Unfortunatley, there aren't any options but just waiting until it resolves.
A normal dose of Botox might cause significant problems in a patient whose nerves are weak.
When injecting Botox, it is important to consider
facial asymmetries; are both brows even? Is there an asymmetry in the frown mechanism that can be treated, i.e. with an injection into the DAO (depressor anguli oris) muscle, or the lips.
It also helps to analyze differences in muscle strength between each side. When evaluating where to inject the Botox and how much to inject, it is helpful for the doctor to ask the patient to animate, and asymmetries can then be brought to light and the dosage of Botox changed accordingly. In some of our patients, we administer literally three times as much Botox on one side of the face to achieve symmetry.
A patient who has recovered from Bell's palsy may have a symmetrical appearance, but when asked to raise the brows or smile, an underlying weakness can be unmasked. Botox dosage is then decreased or eliminated to the weak side. It is the rare Bell's palsy patient that has full normal facial muscle function.
Fortunately for most "drooping problems" from Botox, these tend to dissipate much more quickly than the usual 3 months, since the cause of the drooping is usually a very small amount of Botox at the periphery of an undesired area. The problem could persist for a full 3 months, however, if a full dosage was administered directly into the lip lifting muscles (this problem often arises when aggressive correction of lower crow's feet wrinkles is attempted.
While for most patients this type of problem is an inconvenience, when the patient is a reporter, actress, public speaker or on camera personality, the economic consequences from lost work can be significant.
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