2 weeks ago, I had 20 units of botox in each side of my jaw 48 hours ago, I had radiesse injected in my left cheek (my left was flatter than my right) most swelling has subsided. Now when I smile, the right sidelip turns up but the left side stays flat- (will not raise). What do you think caused this? The jaw botox (kicking in a few weeks later) or radiesse? Hoping it could possibly still be swelling from the radiesse affecting my smile! I went to 2 different doctors- both board certified PS
Have Had Both Botox in my Jaw and Radiesse (Only in One Cheek), and Now I Cannot Smile on my Left Side?
Doctor Answers 6
Cheek weakness from Botox
Most likely this is from the Botox injected 2 weeks ago. It affected the wrong muscle due to it being injected in the wrong area or the product spread post-injection (massaging the area after treatment).
20 units was injected? Why? You don't appear to have any masseter hypertrophy or jowls. I don't see why this was necessary.
I am not clear of when the Radiesse was injected. If the Radiesse was diluted with local anesthesia, you can have weakness in that cheek for a few hours, however this will not last for 48 hours. If you have a signifcant amount of edema on the left side ( which does not appear to be the case from the photo)- the swelling could possibly make the facial nerve a little weak, but this would be temporary and less likely.
Can not tell anything from your photo. I doubt that the problem has anything to do with the radiesse. More likely it has to do with the Botox, and given time will get better on its own. Wait it out
Abnormal smile after masseter Botox is caused by the risorius muscle being affected
Sitting just anterior to the masseter is the risorius muscle. It pulls the side of the mouth laterally. Either the injection was placed too anteriorly or the Botox diffused. It will take 3-4 months to get better. It is not the Radiesse. It seems like more people are getting this injection because there are more reports on Realself about this problem. An experienced injector needs to do this injection.
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Boto or radiesse
The change in your smile could be one or the other or both. Botox if injected high in the cheek could affect your smile. The radiesse swelling may as well.
It was the Botox
It sounds like the Botox relaxed a branch of the facial nerve. This result may last about 3 months and there is not really any way to correct it other than waiting. The good news is that it probably won't be permanent. Botox is not typically injected in the jaw area, so I would strongly consider a consultation with a different physician the next time you are interested in a cosmetic procedure for your jaw area.
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