Botox migration - Can Botox in the forehead cause muscle paralysis in other areas of my face?

I recently had upper eyelid surgery that included the use of Botox in my forehead. At the same time I had Radiesse injected in nasal folds. Five days after these procedures I experienced paralysis in the muscles that control my upper lip. I can't smile and my speech is impaired.

My doctor said the only explanation is that the Botox migrated to the muscles that control my upper lip. Are there other opinions?

3 answers to “Botox migration - Can Botox in the...”

A: Botox migrates other facial areas affect smile

Houtan Chaboki, MD

Botox Cosmetic may migrate partially to affect other facial muscles which were not intended. Normally, small doses of Botox are injected at very specific sites to affect specific muscles to improve facial wrinkles. Occasionally, this Botox moves a bit away from the injection site and weakens other muscles... more

A: Could be from swelling from Radiesse and most probably will resolve

Amir Moradi, MD

Based on my experience, I have injected thousands of patients with Botox and have never had a patient with upper lip issues from injection of Botox in the forehead. Five days after Radiesse in the nasaolabial fold, you can still experience swelling that will resolve and improve the upper lip.

A: Unlikely that Botox migrated to the upper lip muscles

Steven Wallach, MD

It is unlikely that the Botox migrated that far. Perhaps the doctor injected low and centrally on your cheek to treat the crow's feet.  This can hit the zygomaticus major and minor muscles which could impact your smile. If it was from Botox, it should improve within about 4 months.

Comments

Michael Sinclair MD
138 posts
25 Jul 2008

Botox in the forehead has been known to migrate into the upper eyelids causing an eye lid droop. Migrating from the forehead all the way to the upper lip is highly unlikely. Furthermore, even if Botox did migrate from your forehead to your upper lip, it would have to travel through both your upper and lower eyelids. Since your were able to type this letter, and since your are not complaining of not beeing able to open your eyes, then that is extremely unlikely. It is possible that the Radiesse injections caused some trauma to the muscles or nerves which move your upper lip, but that doesn't happen very often either. My guess is that your are having some other kind of problem, and it will likely be temporary. My advice is to get a second opinion from another doctor that can examine you. Michael Sinclair, MD www.epilution.com  

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