55%

471 reviews

Worth It Rating Our index shows the percentage of community members saying this was "Worth it". See cosmetic treatment rankings

Fraxel Laser Cost ≈ $2,200 average cost

Write a review | Ask a Question

Can Fraxel Laser Cause Botox to Diffuse to Mouth?

Recently, I had Botox for frown lines between eyes, lines on my nose, and crow's feet. I also had Juvederm in cheeks. Seven days later, I had Fraxel on face. Two hours later, my smile was crooked. It improved 3 weeks later, but right side around my mouth is still not normal. Could the Fraxel have caused the Botox to diffuse down to my mouth? I had Bell's palsy 30 years ago, but I'm sure it is not related because only my mouth is affected. I am having another Fraxel next week, and am scared that it will happen again.

Asked 34 months ago by Bialli08 in Adelaide

Fraxel Laser, Botox, and Uneven Smile

Hi bia, I have not heard of, or seen this adverse effect with Fraxel, and most of my patients are on Botox at the time of their treatments. If you had a nerve block there is a possibility that the needle punctured or traumatized a branch of the facial nerve. If that is the case, and it is improving, then it should resolve with time. Speak with your treating physician before your next treatment, but I do not think that the side effect is due to the Fraxel treatment. Please let us know how it... more

Michael A. Persky, MD

Los Angeles Facial Plastic Surgeon

Most likely this had nothing to do with the Fraxel

Dear Bialli08 Fraxel is a very well tolerated superficial treatment. If you told us that the fraxel was done right after the BOTOX treatment on the same day, then it would be possible that the pressure applied to the face during the treatment might have pushed the BOTOX around and contributed to the problem. However, you are telling us that the Fraxel was a week later, so this is unlikely. Could swelling associated with the Fraxel exacerbated motor weakness associated with you Bell's... more

Kenneth D. Steinsapir, MD

Los Angeles Oculoplastic Surgeon

Botox and Fraxel

Thanks for your question - It is unlikely that these issues are related. Botox seven days later should not be able to migrate at all. And even immediately after injection it would be likely impossible for a normal dosage of Botox to travel from the upper third of your face to your muscles of facial expression in the lower third of your face. In addition there's no mechanism for Fraxel to cause the botox to move. I hope this helps.

Steven H. Williams, MD

San Francisco Plastic Surgeon

ASPS

No

Botox is injected within the muscle sheath and diffuses minimally after it is injected. After injection the toxin finds it's way to the nerves and enters within a short period of time. Fraxel works by penetrating the dermis only and stimulating collagen production. This is significantly more superficial than the muscle. In addition your treatments were separated by a week. I suspect the smile difference has come from different tightness in the skin secondary to the Fraxel.... more

Christopher L. Hess, MD

Fairfax Plastic Surgeon

ASPS

Fraxel and Botox are most likely unrelated

The Fraxel laser is not likely to have altered the distribution of the Botox. Any stress to the face including surgical trauma, laser or chemical peels may re-activate sub-clinical or latent pox infections which are associated with Bell's Palsy. You may want to consider a prophylactic course of an antiviral medication prior to your next Fraxel treatment. As mentioned in the other comments, nerve blocks may have injured the nerve, altered the distribution of Botox or caused driect... more