Uneven smile and uneven neck. Was injected Botox 20 u around lips and DAO by board certified plastic surgeon? (photo)

This is unfortunate. You have two options. One, just wait for a couple months and the effect will wear off (it may happen sooner). Or, get a little more Botox injected into the stronger side to create more symmetry. Considering how high the one side of your lower lip is, I'd personally just let it wear off.

Andrew Campbell, M.D.

Facial Rejuvenation Specialist



Quintessa Aesthetic Centers

Wow, 20 units is a lot for around the mouth and DAO muscles! Your unfortunate complication is likely a combination of too much Botox and poor injection technique. At this point I would not do anything else and let the Botox wear off. Things will go completely back to normal, but it may take 2-4 months. Sorry about your experience.

I'm not sure when you had your injections, but it can take up to 2 weeks for your final results with Botox. There are a few options to improve this. You can get a touch up of Botox or do Venus legacy treatments to help soften results. Otherwise, Botox will resolve in 3-4 months. See an expert. Best, Dr. Emer

Board Certification in Plastic Surgery is no guarantee that your injector is any good at a particular service.  I for one do not believe that botox should be used around the mouth for precisely this reason.  I do not recommend that you get more botox to fix this.  The service will get better gradually but it can take months.  Find someone else for future service.

Yes, your smile looks uneven. I suggest you see your injector and you can have a "touch up" to make you more even. I always encourage patients to return at 2 weeks when all the Botox perviously injected is maxed out before any corrections. If you're not 2 weeks out then wait to be sure the other side has caught up.

Best wishes, Dr. ALDO

I would recommend making an appointment with the physician who injected your Botox. Asymmetry can often times be fixed with additional Botox, but I would wait 2 weeks to make sure the full effects of the Botox has taken effect.

You had a great deal of Botox injected around the mouth and so many units are what caused this diffusion and droop. Unfortunately it will take several months for this to resolve but it should go back to normal.  Best, Dr. Green

This will resolve.  Unfortunately it will take 3 or 4 months total.  This is unfortunate but can happen if the Botox is injected into adjacent muscles or diffuses into those areas.

Thank you for your
question 465pdb. I am sorry to hear about your situation. Botox is a
purified protein used to address wrinkles associated with facial expression. In the lower face it can be used around the mouth area to reposition the corners of the mouth. In these areas a small amount of Botox must be used. With any Botox injection there is a possibility of spread to nearby muscles such as the DLI, which pulls down the lower lip. This leads to an asymmetric smile. Most people enjoy the results of their Botox treatment for 3-4 months, but this may be longer with higher doses. After that the area should return to baseline. Please consult
with a doctor for specific recommendations. Good luck!

Thanks for your question.  It seems that the treatment for the right DAO muscles may have affected some nearby other muscles inadvertently.  Thankfully this is not permanent and you will eventually even out.  Be well.