J. Randall Jordan, MD

Sorry you are having trouble! While this is not common problem after a facelift it does happen occasionally. Scopolamine patches are fine, but as you said, they have side effects. A more effective treatment is injection of the Parotid gland with a neurotoxin such as Botox, Dysport or Xeomin. This will typically control the secretion of saliva in 5 days or so. While it is theoretically possible to cause a temporary facial weakness with this injection, it is uncommon. Good Luck!

Typically most patients can return to the public eye in 10-14 days, although they are up and around much sooner, usually 2 to 3 days. The bruising that is common is what keeps most patients at home.

Yes, these spots can be treated, but first you need to be exactly sure what they are...are they solar lentigos, commonly called age spots, sun spots, or liver spots; or are they seborrheic keratosis, or are they melanoma or pre-melanoma?  This is best determined by seeing a physician skilled in diagnosing and treating skin problems. Assuming your spots are just age spots or solar lentigos, laser or IPL treatments are commonly used for these, but they can also be treated with prescription skin lightening creams or some of the over-the-counter skin lightening creams. They can also be treated with liquid nitrogen. Regardless of the treatment, they may recur or new ones will form. They are driven by sunlight exposure, so sunscreen is important.

The number of units used is highly variable from patient to patient and depends on a number of factors, so it is not possible to answer this simply. But in a patient who has had satisfactory results in the past and now is requiring either higher doses or more frequent injections, I will typically suggest a switch to one of the other neurotoxins available in the US- either Botoxor Xeomin™.

From the photo- it looks like the right cheek is lower. This could be from the placement of the Voluma™ or from muscle weakness form the Botox™ injection. You should return to the doctor who injected you and yes, it may be possible to correct the smile, or it may go away on its own over several weeks if it is a side effect from the Neurotoxin injection.