Will Botox Help Nerve Damage from Bell's Palsy After 9 Years?

I have some nerve damage from Bell's Palsy. My left eye is squinty, nerve twitching by my nose, and my cheek is tight.It sounds like Botox may help.I had Bell's Palsy roughly 8 years ago. Is it too late for the treatments? Do you think I should go for it? 

Doctor Answers 10

Long standing Bell's palsy

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Long standing Bell's palsy patients are excellent candidates for use of Botox to create a more symmetrical appearing face.  Facial paralysis results in one portion of the face not moving or only partially moving.  When the face animates the non affected side’s movements are often pronounced and can sometimes create abnormal movements called synkinesis.  By placing botox in the overly active side (i.e. the NON-Paralyzed side), the facial movements can look more symmetric in appearance.  This is most easily performed in the upper face and the lower face requires expertise in facial anatomy and facial paresis.  

Chicago Facial Plastic Surgeon
4.8 out of 5 stars 172 reviews

Botox for Residual Bell's Palsy Symptoms

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Great question! I see patients with Bell’s palsy and various forms of facial paralysis on a regular basis and have a high level of expertise with using Botox to treat their residual symptoms. Botox can be very effective for treating the left-over effects of Bell’s palsy much like you are describing. Often times, patients develop synkinesis or a discoordination of the facial muscles that can result in extreme tightening and discomfort. Botox can be strategically injected to help relax certain muscles, which in turn offers patients a lot of relief. While effective, using Botox to treat facial paralysis can be tricky and requires the injecting physician to be experienced and knowledgeable with regards to the facial nerve. If you are considering Botox injections, I urge you to seek the help of a highly specializes physician; a true facial nerve expert to discuss your treatment options. There is a procedure that I specialize in called selective neurolysis which results in natural and spontaneous reanimation of the face that you could potentially be a good candidate for as well. Unfortunately there are very few physicians worldwide who treat facial nerve damage. I see patients from all over the world (both in person and via Skype) who have similar concerns to yourself. If you are interested, I would be happy to discuss your concerns in more detail during a consultation. Feel free to contact me if you are interested! Best of luck!

Babak Azizzadeh, MD
Beverly Hills Facial Plastic Surgeon
4.1 out of 5 stars 9 reviews

Botox for facial muscle twitching

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If you have twitching of facial muscles as your recover from your Bell's palsy Botox can help to stop these movements.  

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 20 reviews

Botox after Bell's palsy works

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To answer your question. YES!. Aberrant regeneation after Bell's palsy and hemifacial spasm can be helped by botox. Most often your insurance will cover it.

Chris Thiagarajah, MD
Denver Oculoplastic Surgeon

Botox Great For Facial Twitching

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Synkinesis is the twitching of the facial muscles with voluntary action of some other facial muscles. Botox can help when injected into the twitching muscle.


Tanveer Janjua, MD
Bedminster Facial Plastic Surgeon
5.0 out of 5 stars 122 reviews

Botox use and facial nerve weakness

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Following Bells Palsy, the muscles on one side of the face may be weaker than the other or the damaged nerve will, in some cases, cause areas of hyperactive contraction of the facial muscles. In either case, Botox can help enhance the balance of the facial muscles and increase symmetry. It is important you find a surgeon who has experience with this and can help you.

Amir M. Karam, MD
San Diego Facial Plastic Surgeon
4.7 out of 5 stars 124 reviews

Botox, facial contouring, Dysport

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Dear Tommy

i have used Botox for facial balancing after Bell's palsy.  it works well but very small doses must be used.

With Warm Regards,

Trevor M Born MD

Trevor M. Born, MD
Toronto Plastic Surgeon
4.9 out of 5 stars 126 reviews

Botox for Bell's Palsy is experimental

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Botox may help treat hyperkinesis (overactive muscles) after Bell's palsy, but it is experimental and requires a good relationship with a patient Plastic surgeon that is willing to spend extra time with you to help solve your problem.  It is definitely worth a consultation.  Good luck

Daryl K. Hoffman, MD
San Jose Plastic Surgeon
4.6 out of 5 stars 16 reviews

Botox and length of time since Bells Palsy

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Botox can provide help for your Bell's palsy regardless of the time since the initial incident. The Botox is typically used on the normal side to relax and make it appear more similar to the weakened side.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 86 reviews


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Botox works by paralyzing the underlying muscles of the face. In cosmetic cases, it is used to lessen the wrinkling of the overlying skin. In your case it would be used to try and achieve a better balance of your remaining facial muscle function. You may have a nice result. It would be a good thing to try, knowing that the effects are temporary and can always be repeated if you like the result. Good luck.

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.