Mouth drooping after Botox for Bell's Palsy

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? 

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12 answers to “Mouth drooping after Botox for...”

A: The key is knowing how much Botox to put in

Philip Young, MD

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... more

A: Not likely Botox

Scott E. Kasden, MD

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.  

A: Tincture of time for drooping mouth after Botox

Otto Joseph Placik, MD

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... more

A: Not a great idea around the mouth

Steven Wallach, MD

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... more

A: Depends on how much Botox was injected in the muscle

Michael J. Brown, MD

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... more

A: Botox

Samson Lee, MD

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.... more

A: Be cautious with prior nerve injury or asymmetry

Brent Moelleken, MD

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)... more

A: In another month or two it will be better

John E. Gross, MD

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.  

A: 2 to 3 months before Botox drooping clears

George J. Beraka, MD

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... more

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

Jordana S. Gilman, MD

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... more

More answers to Mouth drooping after Botox for Bell's Palsy
Dallas - Possibly 1-3 months
New York City - Botox lasts for several months
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