Botox crooked smile and bulging neck muscle

Question

8 days ago i was recommended botox for my chin to help it age at the same point as my forehead. 3 units were injected next to my chin on both sides and 6 units into my chin, it has caused me a pulling feeling a slightly crooked smile and when i smile wide a bulging of a muscle under one side of my chin like im lifting weights or straining, im a 27 year old fit person how long would 3 units typically take to wear off or ease up its unbearable and my injectore on holidays

Martin Jugenburg, MD · Answer

Botox in the right hands can produce a very nice effect in the lower parts of the face.  However with improper technique or migration of the botox it can cause undesirable side effects.  I would recommend discussing your results with your provider.

Jason Emer, MD · Answer

I suggest you consult with an expert as this is likely due to improper placement and will take 3-4 months to resolve on its own.  Best, Dr. Emer.

Nelson Castillo, MD · Answer

Thank you for your question and I am sorry to hear of your issues after Botox administration.  Depending on your appearance you may be a candidate for additional Botox to improve the symmetry in your appearance through paralysis of the bulging muscle, but if you are not interested wearing off of Botox often takes several weeks to a couple of months in a young active individual.  Hope this helps.

R. Brannon Claytor, MD, FACS · Answer

There are many physicians and nurses in our community who inject Botox or Dysport. Periodically a patient comes to see me with a concern of an asymmetry or a crooked eyebrow or smile following a treatment from a less experienced injector. One thing that is important to remember is that asymmetry is more often the norm and that a small amount of asymmetry can be an aesthetic draw. More often this asymmetry was evident before the treatment and may have been accentuated because the patient is now drawn to it once the animation has been muted. Even in the case of extreme asymmetry small doses are broken down more quickly and the undesirable visible changes are short lived.

Alex Eshaghian, MD, PhD · Answer

Thank you for your question jmhanen. Botox can be used to address the dimpling seen on the chin. The muscle that is relaxed is called the mentalis muscle. You have to be sure to use a small amount because there are neighboring muscles that need to be avoided. If the Botox reaches the nearby DLI (depressor labii inferioris) muscle it can lead to an asymmetric smile which lasts up to three to four months. If there is a bulge then the muscle that was intended to be treated may not have been treated completely. I recommend speaking with your doctor. Good luck!

Botox crooked smile and bulging neck muscle

Answers (10)