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Mouth Drooping After Botox for Bell's Palsy

asked 3 years ago by gerliv in sussex uk
Latest answer by Philip Young, MD
Question viewed 7,259 times
Tags: mouth, droopy, bells palsy, side effects

I've had Bell's Palsy since childhood. I'm 47 now, and I had Botox injected in my forehead, the sides of my eyes, and in my chin for the dimple caused by Bell's Palsy. I also had it in the line between my cheeks and nose for the slight twitching. Two days later, my mouth drooped, and it looks like I've got Bell's Palsy again, although the plastic surgeon said it will be okay in a month. It's been two weeks now, why hasn't it gotten any better?

12 answers to Mouth Drooping After Botox for Bell's Palsy

Depends on how much Botox was injected in the muscle

The Botox injection will block the electricity of the nerve from conducting to the muscle that elevates the corner of your mouth. IF the doctor put alot directly into muscle then it may last 2-3 months. If the doctor injected near the muscle and some drifted into the area of the muscle and weakened it, it may last 2-4 weeks. It will not come back like a light switch it will come back slowly over a few days progressively getting full strength. I doubt your prior history has anything to do... more

Michael J. Brown, MD
Leesburg Plastic Surgeon

Tincture of time for drooping mouth after Botox

Time will be your friend. I would not advise that you pursue any other interventions The weakened muscles were likely more susceptible to the Botox. Unfortunately, depsite the best intentions Botox can spread up to an inch from the injection site which includes depth as well. This makes it difficult to predict the extent and distribution of weakness with 100% certainty.

Otto Joseph Placik, MD
Chicago Plastic Surgeon

In another month or two it will be better

Its hard to know for sure, but the injection between your cheek and nose is probably the one responsible. It is likley affecting one of the muscles responsible for lifting the mouth. Unfortunatley, there aren't any options but just waiting until it resolves.

John E. Gross, MD
Los Angeles Plastic Surgeon

2 to 3 months before Botox drooping clears

It may take another 6 to 10 weeks before the drooping clears. The Botox was probably injected into the muscles that lift the upper lip and the corners of the mouth. Botox causes these muscles to relax, and therefore, the mouth falls. Another possibility is that too much Botox was used. This area is much trickier than the upper face and only 2 to 5 units are usually enough. But the good news is it will get better soon for sure.

George J. Beraka, MD
Manhattan Plastic Surgeon

It can take up to 3 months for effects of Botox to resolve

Botox relaxes the muscles that it is injected into. This relaxation stops the twitching, but it also means the muscle itself is relaxed, which leads to the drooping that you experienced. It sounds like the muscle that was treated is one that elevates the mouth, so when that muscle relaxed the mouth appeared to droop. How long it takes to regain muscle movement depends on how much Botox was injected, but I would plan on 2-3 months.

Jordana Gilman, MD
New York Dermatologic Surgeon

Possibly 1-3 months

Greetings, It will get better but it may take some time. The general duration of seeing the effects of Botox is about 3 months. Often though, function will start coming back sooner and you can notice acitvity in 1-3 months. Hopefully you will be on the short end of the spectrum but it may take longer.

D.J. Verret, MD
Dallas Facial Plastic Surgeon

Botox lasts for several months

Botox works by paralyzing the underlying muscles which results in reduction of dynamic wrinkles in the skin. This effect is beneficial in the forehead and around the eyes. However, Botox injections anywhere else can lead to the problems you describe, since Botox not only affects muscles of facial expression, but also functional muscles of the face. You may be okay in a month, but I think it is more realistic to expect several months until the Botox has completely worn off.

David Shafer, MD
New York Plastic Surgeon

www.ShaferPlasticSurgery.com

The key is knowing how much Botox to put in

Botox typically lasts anywhere from 3-6 months. Although certain high movement areas are more likely to get better faster, your current situation could last up to or longer than 3 months. The key is knowing the particular person's state. People with Bell's palsy are likely to react to Botox more than someone who doesn't have this. The reason for this is that people with Bell's Palsy have lost some functioning nerves from the condition and hence when it comes to a neurotoxin they are going... more

Philip Young, MD
Bellevue Facial Plastic Surgeon

Not likely Botox

Botox does not usually start to work until about 4 to 7 days after injection. Since your symptoms started two days after treatment, it is unlikely due to the Botox. You may want to check with a neurologist.

Scott E. Kasden, MD
Dallas Plastic Surgeon

Not a great idea around the mouth

DOem physicians have bee ninjecting Botox around the mouth. Some can get excellent results to soften small lines with very low doses. However, there is a risk to develop the problem that you described. Unfortunately, it will last as long as the botox hangs around. This usually is 3-4 months not 1 month or a few weeks.

Steven Wallach, MD
Manhattan Plastic Surgeon

Botox

I'm assuming you had normal function before your injection of Botox. Any injection of Botox in the area of the mouth has the risk of causing temporary facial paralysis. Depending on the amount of Botox used you eventually will completely recover to your baseline however it is unpredictable when that would be. I would assume 1-2 months. It likely will slowly get better with time. Because of your history of Bell's Palsy and I assume mild weakness of that side of your face I would be very... more

Samson Lee, MD
Seattle Facial Plastic Surgeon

Be cautious with prior nerve injury or asymmetry

A normal dose of Botox might cause significant problems in a patient whose nerves are weak. When injecting Botox, it is important to consider facial asymmetries; are both brows even? Is there an asymmetry in the frown mechanism that can be treated, i.e. with an injection into the DAO (depressor anguli oris) muscle, or the lips. It also helps to analyze differences in muscle strength between each side. When evaluating where to inject the Botox and how much to inject, it is helpful for... more