Can Fraxel Laser Cause Botox to Diffuse to Mouth? Doctor Answers, Tips
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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.

5 Doctor Answers | Asked by Bialli08 in Adelaide
+2

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
+2

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
+1

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.

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+1

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
+1

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
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Comments (2)

jm2ndfraxel 1 Jan 2013
I am having a similar problem . I had fraxel 48 hrs after Botox. My left eye does not clise completely. My left upper lip droops, I can't raise either upper lip to smile. I had a lot of cheek swelling as well as swelling around the jaw line. This corresponds to where the facial nerve and the branches inner sting the upper lip travel
Bialli08 1 Jan 2013
I am finding it hard to recall as it was so long ago but after seeing a plastic surgeon on m skin pigmentation he believes that the botox injection was the cause. There is a nerve that is under the eye next to the nose that the injection went into that over time the botox diffused down to mouth. It was so embarrassing and as I had bell's palsy 30 years ago, I blamed it on a recurrence! This was a big fat liar but think I got away with it. Over time it slowly came back to normal. The same thing has happened when I have had juvederm around upper lip. So now I leave the lip alone and do not get my bunny lines injected. I feel for you, especially if you smile alot. I didnt want to go out and felt so self conscious. I now only have botox in brow and smile lines on the outer eyes and also jevederm in lower cheeks. I do have it written down somewhere about the events that transpired last time so if you want to know more I will let you know.

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