Chin Tightens and Locks Involuntarily After Botox

I routinely inject the mentalis muscle int he chin for chin dimpling.  I have injected the mentalis muscle in over 500 patients, and in my experience, I have seen two patients who have complained of some asymmetric cramping, or twitching of the mentalis muscle as the Botox wears off (after 3-4 months). It is very uncommon, and I imagine annoying, but not permanent. In both cases, this cramping lasting 1-2 weeks and completely resolved. One patient decided that it was annoying enough for her that she no longer wants botox in this area, and one patient liked the results so much that she considered the 1-2 weeks of twitching a minor annoyance, and opted for repeat Botox injection. She never had the issue again. 

It sounds like there may have been an asymmetric mentalis muscle Botox injection or uptake. Although not common, this kind of unoppossed or asymmetric attenuation can lead to hyperreflexive contraction of the less attenuated muscle. Clearly this will wear off spontaneously but it may take up to 6 months. I would manage this by Botox or Dysport injection of the hyperactive mentalis muscle. I expect improvement in 2 days and complete resolution by 10 days. There is usually a learning curve with each injection and if you decide to have subsequent maintenance treatment of your chin pitting with a neuroattenuator like Botox or Dysport, you will likely not experience the same problem as your provider becomes more comfortable with your injections.