Uneven Smile Lines from Botox

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 lip so that there can be more sagging of the cheek with more wrinkles and more sagging of the upper lip. This doesn't happen very often, but can be distrubing when it does... more

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.

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

As unusual as this sounds, it could be true. Some injectors use such high doses of Botox around the eyes for crow's feet that the outer cheeks can sag down, and the excess Botox can migrate downward in the face, causing an important smile muscle to be affected. Luckily, Botox is temporary, and any bad effects do wear off. Make sure your Botox is being injected by a board-certified dermatologist or plastic surgeon and that you are not being overtreated. If you are not... more

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 not see what you see, then I suggest seeing a Board Certified Plastic Surgeon for an evaulation. I hope this helps! Dr. C

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.

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. The good news is that if the asymmetry is due to the Botox - you will slowly see improvement over the next 4 to 8 weeks. I also recommend that you have a Board Certified Plastic Surgeon... more

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 asymmetric. It is hard to tell if this is the case with you since there is no picture and I can't examine you. Also, you do not state how long it has been since the Botox injection. If... more

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, you should see some improvement in 1-2 months as the Botox begins to wear off. One good feature of Botox is that its effects are not permanent. Good luck.

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 effect until about 3 weeks after treatment. Small doses like those used in the crowsfeet area do tend to wear off a little faster than larger doses. Another issue is that some doctors... more