Ask a doctor

When Botox is Injected in the Upper Lips, is the Result Permanent or Can It Be Reversed?

My smile is crooked, one side goes down farther than the other. Also, I cannot spit or enunciate clearly. Will this go away and if so, when?

Doctor Answers 14

Fortunately, Botox effects are not permanent

Fortunately, Botox effects are not permanent.  As botox effects will wear off in about three months, you will return to your pre-botox state.

Toronto Plastic Surgeon
5.0 out of 5 stars 312 reviews

Wait a few months and it will return to normal

I'm sorry to hear that your results were not as you expected. Fortunately for you, Botox does not achieve permanent results. A treatment tends to achieve results that last about 3-4 months, or a little longer if you've received several treatments before. If you wait, this will gradually go away.

The effects of botox are temporary - 3-5 months

Botox lasts 3-5 months.  It always wears off.  Injecting botox into the upper lip helps

  1. reduce lines from pursing of the lips
  2. lengthens the upper lip, reducing "gummy" smile and
  3. reducing the amount of lip that curls under when we smile.  This can be particularly helpful when the upper lip "disappears" when the patient smiles

Injection of the upper lip is an advanced technique.  A small amount goes a long way.   Potential side effects of lip injection include asymmetry, change in enunciation, and inability to whistle or suck through a straw.  I would never inject into the upper lip of a patient that makes her living through her voice (singers, radio announcers, etc).  I use a very conservative amount. Whereas 20-30 units is a typical dose for the glabellar region, a typical dose to the upper lip is 3-6 units.

Botox in the lips

Botox can be used delicately and sparingly on the lip lines to help efface them. However, too much may affect the movement. It takes about 4 months for this to completely wear off.

Steven Wallach, MD
New York Plastic Surgeon
4.0 out of 5 stars 22 reviews

Botox in the upper lip

The effect will go away, and there is nothing you can do to speed that process.

As I think you can see from the answers already, botox in the upper lip is touchy, with a very small therapeutic window. Meaning it is very difficult to get just the right amount in place that will last an appropriate amount of time and not have too many side effects.  That's why I have stopped suggesting it to patients.  Unfortunately for you, this might be a difficult lesson learned.

Botox usually lasts 3-6 mos, so you might see lingering asymmetry to your lip and smile for up to 6 mos.  However the precise, small doses typically used in the upper lip are small enough that you will most likely experience a return to normal closer to three months.  Hang in there.

Kevin Robertson, MD
Madison Facial Plastic Surgeon
4.5 out of 5 stars 12 reviews

Botox Effect is NOT permanent - Good News with Overdone Lip injections

Regarding: "When Botox is Injected in the Upper Lips, is the Result Permanent or Can It Be Reversed?
My smile is crooked, one side goes down farther than the other. Also, I cannot spit or enunciate clearly. Will this go away and if so, when

To smooth deep smoker's lines, VERY small amounts of Botox MAY be injected in the upper lip to slightly weaken the underlying muscle. If the threshold of minute weakening is passed, as it sounds like it was done in your case, the Orbicularis muscle does not function well losing the ability to enunciate certain letters, or keep fluids in the mouth. The effect can last 3-4 months depending on the dose of Botox given.

Peter A. Aldea, MD
Memphis Plastic Surgeon
5.0 out of 5 stars 83 reviews

Asymmetric smile with Botox

Botox is temporary and tends to resolve completely by 4-6 mopnths. Anything that persists beyond this period is unlikely to be related to the Botox.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
5.0 out of 5 stars 60 reviews

Botox for the upper lip

If I inject Botox in the upper lip (which is seldom), I inject minute quantities (maybe 1-2 units per side).   Unfortunately, now you know why.  The good news is that the effect WILL go away.  It generally lasts about 3-4 months.  I wish there was a way to reverse it, but there isn't. 

Matthew Bridges, MD
Richmond Facial Plastic Surgeon
5.0 out of 5 stars 14 reviews

Botox NOT Good Around Mouth Area

The asymmetry you are experiencing is not that unusual when people inject around the mouth.  Luckily, it will al resolve on its own between 3-5 months.  This is one of the reasons that Botox really is not ideal for the mouth area.  It often paralyzes segments of the muscle more on one side vs. the other.  Because of this, you get asymmetry and a crooked facial expression.  Just be patient and it will wear off on its own.  In the meantime, tell people you have some facial palsy from a viral infection - noonewill know the difference.

Botox is never permanent

If you have a muscular unbalance from the Botox don't be concerned that it's permanent. It will all go away by four months, latest five; usually around three months most of the ill-effect is no longer seen.

Ronald Shelton, MD
Manhattan Dermatologic Surgeon
5.0 out of 5 stars 34 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.