Uneven smile lines from Botox

I just got botox for my crow's feet and it's making my frown/smile lines uneven. It may not seem noticeable but one side of my smile lines looks deeper and longer than at the other side. What should I do? Is there something that can even it out or do I have to wait for it to go away? Will it fade away faster since that is not where the Botox was injected, and how soon will it be?

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9 answers to “Uneven smile lines from Botox”

A: Botox lines

John Philip Connors III, MD

Botox typically takes 3 - 7 days to start to work and is maximally active at 2 weeks. I suggest that you see your injecting physician. If your are greater than 2 weeks out and still feel uneven, he or she may be able to "fix" the area of concern with small additional doses of Botox. If they do... more

A: Botox and Lines

Steven Wallach, MD

If you just got Botox injected you have to give it some time to work. This may take up to a week. Remember, asymmetry is normal and may not have appreciated some differences before you were injected.

A: Botox causing uneven frown/smile lines

Daniel Reichner, MD

Mary It is a good idea to have a Plastic Surgeon examine you for a proper diagnosis.  That being said, It is possible when injecting Botox to weaken the muscles that are responsible for your smile.  If you noticed a significant difference several weeks after the injections this may be the problem... more

A: Almost certainly from Botox, and should go away as the Botox wears off

E. Anthony Musarra II, MD

Botox prevents the transmission of the electrical message from a nerve ending to a muscle fiber, preventing the muscle fiber from contracting. Botox has the potential to spread from the area that was injected. Botox injected in the crow's feet area can spread to the muscles that control your cheek and upper... more

A: If they injected too deep or medial, it may have affected the cheek muscles

David Shafer, MD

Mary, Botox Cosmetic is very effective for crow's feet. However, if your injector injected too much volume, too deep, or too medial, then it is possible that the Botox will affect the cheek muscle which help you smile. If this happens, then the affected side will have a slight droop and your smile will be... more

A: Uneven smile lines from Botox is uncommon

Bryan K. Chen, MD

What you are experiencing does uncommonly occur to certain individuals whose crows feet are injected with Botox. I suggest you bring this matter to the attention of your doctor.  He or she can assess you in person and possibly offer a touch-up to even out the smile lines.  If you do nothing further,... more

A: Botox results will improve with time

Kenneth D. Steinsapir, MD

There are any number of reasons for facial asymmetry. It could be that Botox was placed a little differently on one side than the other. Or it might be that the two sides of the face are slightly different. Recognize that while Botox effects can be seen within 24 hours, the treatment is not at its maximum... more

A: Wait and be patient

Darrick E. Antell, MD

Without the benefit of examining you, it is possible that the smile lines were uneven before the Botox was administered. Having said that, I would wait it out and re-evalute the situation. You should return to the doctor that administered the product for evaluation and recommendations.

A: Uneven Smile Lines After Botox

Michael A. Persky, MD

Hi Mary, Your question is best answered after examining your face and seeing how your facial muscles are moving.  You should discuss this with your injecting physician, or see a Botox expert who should be able to "even" you out.  Good luck and be well. Dr. P

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