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Thank you for showing both photographs. I have had great success with using Botox for just your problem. You can inject Botox on either side of the nares to keep from lifting the upper lip too much thus showing less of your gums. I would definitely try an easy fix with Botox before looking into dental work or fillers. You have a beautiful smile with nice straight, white teeth and sometimes less is more. Good luck, please consider trying the Botox first.

Hi there! I’ve always had a pretty smile but lately, the crookedness is driving me crazy. Sometimes it looks like this and other times not. Do I need my gums corrected? Veneers? Botox in surrounding muscles? As you can see, I seem to not have the problem in selfies I take, so it seems I’m correcting it when I see myself in a mirror. Thoughts?

Why is my smile crooked? Gums? Thoughts? (photos)

The best answer I have is there is no data. The Covid vaccine is new and there have been no studies that I am aware of. On the other hand, I have continued injecting Botox during the pandemic and vaccination periods and have not experienced any complications in any of my patients. Botox works in the junction between the nerve and the muscle to block the signal from the nerve that causes the muscles to contract. The vaccine causes the immune system to form antibodies to combat infection with the Covid virus. The mechanism of action for Botox and Covid vaccine differ so I do not feel there should be problems continuing with Botox treatments while having the Covid vaccine.

Is it safe to get Botox and then 4 days later the second dose of vaccine?

I have some patients that have had previous head injuries that do wonderfully with Botox injections. There can be long term numbness or altered sensations in any area where trauma has occurred in the past. The Botox is working locally at the junction between the nerve and muscle which interferes with the conduction of the nerve impulse that tells the muscle to contract. There are nerve endings in the forehead which can cause bizarre sensations when triggered. I think this is what you are experiencing. Some people will sneeze when the Glabella (area between the brows) is injected. Other areas might feel like the hair is being “pulled” at the top of the head. I would consider seeing if there is an area on your forehead that reproduces the feelings you had after the Botox. You may try a gentle tap on the forehead with your finger to isolate the area. If you find a spot that is sensitive you can avoid injecting in that area.

Around 11+ years ago, I fell and hit my head on a concrete floor and got a concussion. As a result, the front top right of my forehead/head area has been mostly numb which I believe is related to nerve damage. Last July, I got botox in my forehead and in one of the injection sites, I could feel a sensation on the back of my head. This lasted for a week or two and then went away. Ever since, I've been nervous to get botox again but is there any reason why I shouldn't?

I had some nerve damage on my forehead from a head injury, am I safe to get Botox still?

This is a question that is asked of me by my patients on occasion. I have had 15 years of experience with injecting Botox and have never seen an allergic reaction to Botox. Botox, as with any other injection, always carries a slight risk of bruising, infection, allergy or undesired effects. I do occasionally bruise someone but have not had any infections, allergies or systemic (body) problems. Botox in my opinion has been a very safe product. I have encountered people that Botox has not worked on no matter how much I have injected. When Botox has not worked I then try a different neurotoxin such as Dysport or Xeomin. I have found that Botox tends to wear off faster in patients that work out a lot, such as runners, triathletes and cyclists. I have also found more muscle movement first thing in the morning or when muscles are cold. I hope that alleviates your concerns. Botox is a great way to prevent wrinkles and can be used for many years for most without allergies or resistance.

What are the chances you could have antibodies to Botox before the first treatment? What are the chances you could develop antibodies to Botox if you began at only 23 years old?

Botox resistance and allergy: What are the chances of being allergic to Botox?

Uneven eyebrows are a common finding. No person has completely symmetrical facial structure and in some it is more noticeable than others. I have used Botox for many women to help even off the eyebrows. I would lower the elevated brow a little with the Botox and see how that looks. The beauty and beast of Botox is it wears off. If you don’t like it, it wears off and if you love it you will need to repeat injections every 3-4 months. The combination of Botox and then brow shaping with an esthetician works well.

Hi, I've struggled for so long with my appearance about my eyes/eyebrows. One eyebrow is much higher than the other and makes my whole face look droopy on one side. I've worn a fringe for 20+ years as I was so self conscious. Please help :-(

Can anyone help with eyebrows (one is much higher on my forehead that the other)? (Photo)

You may respond nicely to a Botox treatment at the back of your jaw. I have used Botox to help slim the appearance of the lower face by injecting Botox into the masseter muscles, the muscles which are used to chew. The injections help to decrease the squared appearance of the jaw. These muscles may also be injected for patients who grind their teeth as you do. I have also treated patients with a cobblestone appearance to their chins using Botox and softening the downward pull at the corners of the mouth. Theses are all common off label uses for Botox that help the appearance of the lower face. It is great to have non surgical options available. You will benefit from an in person evaluation to fully assess your facial structures as one photo does not show all that is necessary to provide you a complete assessment, but it sounds like a good treatment for you.

Hello, I’m wondering if masseter Botox would help slim my jaw (it is especially pronounced on one side). I grind my teeth in my sleep (have done this since I was a child) and I have a bad habit of clenching my jaw. Would I run the risk of developing jowls from the Botox? Thanks!

Am I a good candidate for masseter Botox? (photo)

You may respond nicely to a Botox treatment at the back of your jaw. I have used Botox to help slim the appearance of the lower face by injecting Botox into the masseter muscles, the muscles which are used to chew. The injections help to decrease the squared appearance of the jaw. These muscles may also be injected for patients who grind their teeth. I have also treated patients with a cobblestone appearance to their chins using Botox and softening the downward pull at the corners of the mouth. Theses are all common off label uses for Botox that help the appearance of the lower face. It is great to have non surgical options available. You will benefit from an in person evaluation to fully assess your facial structures as one photo does not show all that is necessary to provide you a complete assessment.

As you can see I have a very prominent lower face. I sae that one can inject Botox in the masseter to make the jaw look more „soft“ and feminine. Would this help in my case too? Ps: surgery is not an option for me.

Could I benefit from injecting Botox in my lower face to make it appear softer? (photo)

You have discovered the world of asymmetry. No person is completely the same on both sides. You are right and left handed. You are also controlled by different nerves from different sides of your brain to use muscles on opposite sides. Your facial muscles do not work exactly the same on each side and therefore lines can be different from side to side as well as eyebrows. I am pleased to say there are ways to help balance eyebrows with Botox. You will need to discuss this with your injector to see how they may help balance your brows. I would suggest trying the Botox and then seeing an esthetician to shape your brows. Good luck, I’m sure you will find a good improvement.

Also my eyebrow is lower and my nose slightly crooked this side (left). Can this be due to a general facial muscle imbalance? Actually all my body is tighter on the left.

Is it possible I have a stronger corrugator muscle on one side pulling my single vertical frown line? Is Botox right?

I have some questions for you to consider. Was this your first Botox treatment? If not, did you go to a new injector? Did you have your usual amount of Botox? Did you have some residual Botox in your forehead from a previous treatment? Now that I have you thinking, there can be a number of answers to your question. The muscles in the forehead hold up your eyebrows. Some people are very sensitive to the amount of Botox used in their foreheads and the eyebrows can flatten and drop. Too much Botox for the person or placement over the lateral, outside end, of the brow can flatten and drop the brow. The good thing about Botox is that it wears off. I suggest you speak with your injector, send them some photos or better go in and talk to them. Hopefully the injector has notes of the injection pattern and will be able to go over them with you. Make plans for how much Botox to use next time and what injection pattern to use. Don’t be afraid to try it again. Good luck.

3 days ago I was putting on my makeup on my forehead and my forehead tensed up and tingled and my eyebrows flattened/dropped I quickly raised them back up with my hands and they went back to normal. Today I was using a makeup remover wipe and the same thing happened. I was able to put them back, but why is this occurring??

Got Botox a month ago, 33 units on my forehead & between my brows, what could be causing tension, tingling, & flattening brows?

Good question. I typically start my injections for the glabella area at 20 units of Botox. It takes up to 2 weeks for the final results of your treatment and you may need a touch up at that time. If there is still movement you will want a little more added. Botox will not take away lines that are there at rest but over time many will improve. Botox stops the muscles from contracting, the ones which cause the lines to develop in the first place. Once the muscles are no longer reinforcing those lines you may begin other therapies to work on the skin itself. Skin care products, peels, micro needling, radio frequency or laser to name a few. If the Botox wears off too soon , before 3 months, you will need a larger dose for your treatments. The Botox will help prevent permanent lines from forming or getting worse. Good luck with your Botox treatment, I hope you will find the results amazing.

I have always had noticie lines inbetween my brows after I frown and as I've gotten older they seem more noticeable and stay on my face longer. I I want to prevent this from getting worse and maybe try to reduce their appearance now. I think Botox is the best option. How many units will I need?

How many units of Botox will this need? (Photo)

Peggy Bleezarde, MD

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I have been getting Juvederm and Botox on and off for years with Dr. Gregory. I have migraines and there are a few locations on the back of my head she’s been willing to experiment with me on and I also have a very asymmetrical depression under one eye after an accident and chronic headaches on that side of my head. Dr Gregory has helped fill the tear trough and depression to make it less noticeable and I have never had bruising once from any of her injections. I usually don’t even need ice because her injection technique leaves minimal swelling.

Individualized treatment - never had bruising from any of her injections

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Peggy Bleezarde, MD

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Individualized treatment - never had bruising from any of her injections

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Peggy Bleezarde, MD

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PEGGY BLEEZARDE, MD REVIEWS

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Individualized treatment - never had bruising from any of her injections

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