Is Botox Safe To Use In My Face If I've Had Bells Palsy?

Kate

BOTOX can be great for this situation.  However, what you need is an experienced injector with experience treating patients with Bell's Palsy.  This is not a situation where you should go down the street to the store front with the "nurse" doing treatment with no doctor around.  Oculoplastic surgeons, facial plastic surgeons, and specialized general plastic surgeons are going to be better choices for core specialists treating this situation.  You might consider looking at my Microdroplet BOTOX method which has the advantage of being adaptable to the individual and it creates lift.  Precisely what you need very much depends on your examination and how the muscles of facial expression were affected by the Bell's Palsy.

BOTOX is safe to use on a patient with a history of Bell's Palsy. However, I strongly recommend that this injection be done by someone who is very familiar with anatomy of the face and familiar with injecting patients with Bell's Palsy.

If you have a history of Bells Palsy and are thinking of getting botox injections for wrinkles, you should see a physician with a lot of experience with these injections.  Often times, the patient  will have excessive wrinkling and muscle movement on the unaffected side, and Botox treats this wonderfully.  If an area is drooping it may not actually lift it, but weakening of the stronger side could make you look more symmetrical.  If an area of the affected side is contracting in a spastic manner, Botox could also improve that as well.  It is a safe treatment option as Botox has been around for more than 25 years.

Some patients have Botox to recreate symmetry after being affected by Bell's Palsy. However, if there is a risk for you to have an unsatisfactory cosmetic result and it is within five months of your wedding, I would suggest you not have the Botox as it could take four months to have the effect fully disappear and you need time for photographs possibly before the wedding. If you have a treatment more than five months before the wedding and like the results, then you might consider having the same treatment two months before the wedding by the same doctor with the same number of units understanding that at any treatment there could be a result that will be unsatisfactory. The risk of this may not be worth it prior to the wedding! 

Botox is actually one of the mainstay treatments for patients with a history of Bell's Palsy who develop a phenomenon called "Synkinesis."  Synkinesis is an uncoordinated movement of the face that occurs when the nerve regenerates in an abnormal pattern.  The treatment for synkinsis included neuromuscular retraining as well as botox or dysport.  There are some risks with botox but overall patients get great outcome if it is done by a facial nerve expert.   If you are near the beverly hills area feel free to come to my office.

Bell's palsy is a nerve injury of the facial nerve which controls the muscles of facial expressions. Typically, there is no known cause why this happen (otherwise it is not called Bell's palsy), however a number of experts believed that a viral etiology is a culprit in many cases. One example is the Ramsay Hunt syndrome which is secondary to a herpes zoster infection affecting the facial nerve near one of the ears. Most cases of Bell's palsy recover without residual deficit in facial expressions. However, if the injury is severe, say greater than 70% nerve damage ( can be checked by electrodiagnostic testing) the facial nerve may recover some function but will produce aberrant regeneration of the nerve, meaning that there maybe abnormal inter-connection of fibers supplying the muscles causing asymmetric and uncoordinated movements in facial expressions. This may result in synkinesis resulting in an asymmetric smiles, and oftentimes closing or narrowing of the eye of the affected side every time the patient talks or smiles. This is where botox injection is useful because it can help in providing some symmetry of facial expressions for cosmetic reasons, and also helps balance the movements of the muscles of facial expressions for coordinated movement and less discomfort to the patient. Botox injection can also help  patients  who are doing or planning to do neuromuscular re-education  therapy (usually with the help of a Therapist) to improve muscle coordination. You can see a Specialist with experience in this field more more insights.

In fact Botox can be used to correct the facial asymmetry of Bell'sPalsy. I don't feel that there is a risk of re-activating your Bell's Palsy.

I have had great success treating a patient of mine who had Bells palsy about 20 years ago. She is a Ford model and no one even comments on her asymmetry! I have been able to reduce her asymmetry with Botox by treating a few overacting muscles and avoiding treating areas with persistent weakness. She and I are both very pleased.

Hi Kate.

Botox often can help the complications of Bell's palsy, and I have many such patients, so you are definitely a candidate for Botox.  Your particular desires may or may not be related to the Bell's palsy.  Go to a specialist that treats complications of Bell's palsy so that you get the optimal result.  

Dear Kate, Botox is certainly an option for someone who has had Bells Palsy in the past.  In fact, it is a treatment for Bells Palsy patients who have developed synkinesis, or abnormal re-wiring of the nerves as they heal.  This often causes spastic contraction of the surrounding muscles.  So a history of bells palsy alone is not a contraindication.  However, I would suggest you see an oculoplastic surgeon who is experienced in botox injections and Bells Palsy, because certainly if done incorrectly, can add to your residual weakness.  It may be a good idea to wait until your wedding is over just in case you don't like the results.

Good Luck,

Jasmine Mohadjer MD

Oculoplastic Surgeon

Tampa Bay, FL