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Botox - How Long Before Numbness and Drooping Wears Off?

I have had Botox previously and they only did inbetween my eyebrows and the few lines above that area. Now, I went back and the new DR there, injected my entire forehead and my upper lip. I have no feeling whatsoever in those areas.

Not only do I have the droopy eyelids, I can not feel my upper lip. I am having trouble eating, drinking etc. I can't even whistle! What can I do?? I had no problems from the first treatment 8 months ago. Do I have to wait that long without feeling in my face and not being able to eat or drink or even smile right?

Doctor Answers 22

Fortunately the results are completely reversible...be patient and you will return to normal

Fortunately the results are completely reversible...be patient and you will return to normal. There are eye drops that may help temporarily to stimulate your upper eyelid muscle to contract and raise your eyelid if the droopiness is due to a direct effect on the eyelid muscle. If, however, it is due to an imbalance of your eyebrow raising/lowering (forehead) muscles, then the drops will not work.

You may have the impression that you cannot "feel" your lip, but Botox does not effect the nerves that carry sensation, rather only the nerves that carry the signals to muscles to move.

You don't have to give up on ever having Botox again, just be sure that you discuss your recent results thoroughly with your (next) treating physician.


Coral Springs Plastic Surgeon
5.0 out of 5 stars 33 reviews

Unfortunately there is not much you can do. The Botox...

Unfortunately there is not much you can do. The Botox will wear off in about 3-4 months. You will probably notice some improvement before then as the muscles start to come back. Unfortunately though there is no way to reverse Botox so it will just have to 'wear off'.

D.J. Verret, MD
Dallas Facial Plastic Surgeon
4.0 out of 5 stars 13 reviews

Botox Injections

The great thing about Botox is that it always goes away.  The bad thing is that it may take several weeks to months.  Please make sure that you are injected by an experienced board certified physician.  Good luck.

David Shafer, MD
New York Plastic Surgeon
5.0 out of 5 stars 64 reviews

It will most likely wear off before the Botox does

Botox has very few side effects; however, one of the most troubling to patients is when an eyelid droops. This side effect is rare and happens less than 1% of the time. The drooping eyelid syndrome is not permanent. It will most likely wear off before the Botox does. If eyelid drooping starts three to four days after the injection, it will most likely last three to six weeks. If the drooping begins four to six days after the injection, it should go away faster. In the time it takes to wear off, the doctor might prescribe a medication by way of an eye drop that may reduce the drooping.

Sanusi Umar, MD
Redondo Beach Dermatologic Surgeon
5.0 out of 5 stars 27 reviews

Botox

The effects of Botox usually dissipate within 3-4 months. However, I have never heard of patients becoming numb from the Botox.  Very unusual, are you sure it was Botox?

Steven Wallach, MD
New York Plastic Surgeon
4.5 out of 5 stars 20 reviews

Be patient- your Botox results will wear off

 

These days, many doctors are offering Botox treatment. It is important to remember that Botox is still a medical procedure and one that should only be performed by physicians who have great deal of experience with this medicine. I'm sorry to hear that you develop these problems with Botox. The bad news is that not a great deal can be done to reverse the symptoms. The good news is that Botox will eventually wear off in 4 to 6 months. Although it may be tough to do at this time I would counter blessings that these are not permanent changes and next time doublecheck your doctor's credentials and level of experience with this medical procedure

For more information on Botox or to schedule an iConsult, please visit us online at: 

Pat Pazmino, MD
Miami Plastic Surgeon
4.5 out of 5 stars 67 reviews

Be Patient and Always Check Credentials!!!

Sorry to hear about your results. When BOTOX Cosmetic is administered correctly by a trained and experienced injector, there should be a very low chance of adverse results. From what it sounds like, I would check the credentials of this new injector and see what type of experience they actually have with the use of BOTOX.

 

Because BOTOX affects motor nerves, it is rare to have numbness following treatment. The droopy eyelid might be able to be treated depending on whether it is a drooping eyelid or a drooping brow. You should see the treating physician and have he/she address this. If they are not comfortable treating this adverse outcome, ask them to recommend someone who is. As for the drooling, treatment around the mouth can be tricky and overtreatment can lead to inability to form a tight seal of the lips and, ultimately, drooling. This will fortunately wear off but it may take several weeks to a few months to see a difference. One thing that can be useful is to have a small amount of Juvederm or Restylane injected around the borders of your mouth to effectively stiffen the lip somewhat. This can sometimes help with closure.

At least it isn't permanent......

This is a very unfortunate situation as only time will fix the problem. I remember one lady who I had treated with Botox many times who wanted it all around her lips for her 50th birthday party. She came in telling me her friend had it done around her eyes and cheeks and lips by Dr. Docwholearnedbotoxatweekendcourse and would I do it? I had only ever treated between her brows and forehead and explained to her that Botox injections work well in certain areas but in the wrong amounts or even in the slightly wrong place can do what you are describing. She left me and went to the other doc who promptly treated her. 2 weeks later she came back to me crying that her 50th party was coming and it looked like she had a stroke around her mouth! I told her that unfortunately there wasn't much that we could do except wait it out. Not only did she have droopy eyelids but her smile was completely asymmetric. Your story highlights the point that it was a "new" doctor doing Botox there. You didn't mention if it was a plastic surgeon or dermatologist or ENT/facial plastics doc who would understand the anatomy and inject appropriate amounts in appropriate places. All throughout the country docs learn how to inject Botox (as a source of cash income) who were not trained in cosmetic surgery. In my area there are several Botox factories with docs that trained in internal medicine/family medicine/emergency medicine, etc...While perhaps they do a good job, it would seem to me that doctors should do what they are trained in. That is my opinion and only an opinion, however would you go to a plastic surgeon to treat your flu? Would you go to a plastic surgeon if you were about to deliver a baby? Would you go to a plastic surgeon if you were having chest pain and thought it could be a heart attack? It is more likely you would go to a doctor trained in that specialty. Most docs are certified in something. Remember that. I hope that from your story perhaps some people will do their homework and protect themselves from outcomes such as you describe!

Numbness and Drooping after Botox

The good news is that this is NOT permanent, and you will likely NOT have to wait 8 months...

You are discussing a number of symptoms so let's discuss each:

In terms of the lip function (whistling, eating, drinking, etc.) -- although it usually takes 3-4 months for the effects of the Botox to wear off,  it typically tends to last less around the mouth.

In terms of the eyelid droop, this too does not last as long as the full duration of the Botox.  It should return sooner.  Fortunately, the eyelid droop tends to last shorter because the full Botox dose doesn't usually diffuse into the muscle that elevates the eyelid.

In terms of the forehead and lip sensation, it feels weird because the muscle function in that area was targeted by the Botox.  Botox, in and of itself, does not affect the receptors that govern sensation.  It may "feel weird" in that area because the muscles are paralyzed by the Botox, but the surface skin sensation should be normal.

So what options do you have in treatment...

A droopy eye-LID due to Botox can be treated with Apraclonidine eye-drops which can provide a small (2mm) improvement -- Apraclonidine 0.5, 1-2 drops, 3 times per day. Make sure you put in one drop at a time, tilt your head back, and close your eyes to make sure none of the eye-drop leaks out.

Be sure your prescribing physician discusses all the potential side-effects of the drops, such as "adrenaline-like" symptoms like anxiety or heart pounding; you may also experience eye irritation, eye dryness, and eye pain, amongst other symptoms. If these symptoms occur, you will likely need to take some lubricating eye drops, lower the dose, switch the eye-drops, or stop the drops altogether...

In the future, be sure to seek the services of an experienced physician injector. I think the key with Botox lies in truly understanding the anatomy of the injected area, and more importantly the variability in the anatomy between patients -- for brows, the forehead, and anywhere else you plan on receiving a Botox injection. This includes having a firm understanding of the origin, insertion, and action of each muscle that will be injected, the thickness of each muscle targeted, and the patient variability therein. As an aesthetic-trained plastic surgeon, I am intrinsically biased since I operate in the area for browlifts and facelifts, and have a unique perspective to the muscle anatomy since I commonly dissect under the skin and see the actual muscles themselves. For me, this helps guide where to inject and where not to. However, with that said, I know many Dermatologists who know the anatomy well despite not operating in that area, and get great results.

Good luck.

Botox May Take Up to 4-8 Weeks For Resolution

Botox injections are associated with high levels of patient satisfaction and low complication rates. Unfortunately complications related to migration of botox can occasionally occur. Migration of  botox can result in a droopy upper eyelid and weakness of the upper lips. Botox only affects motor nerves, it doesn't affect sensory nerves. For this reason, numbness of the forehead and lip can't be explained by the use of botox.

When eyelid and lip symptoms occur following the use of botox it usually takes about 4 to 8 weeks for spontaneous resolution. This varies depending upon the amount of botox given and the strength of the underlying muscles.

When patients are unwilling to wait for spontaneous resolution several options are available. These include eye drops which partially reverse the impact of botox. These include the eye drops Alphagen and Lodysine. Both are associated with excellent clinical responses and high levels of patient satisfaction. Unfortunately, there are no treatments currently available for lip weakness.

If you've developed eyelid sag and lip weakness following botox it's important to consult a board-certified plastic surgery. This surgeon should be able to make an appropriate recommendation.

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.