Botox on chin made my bottom lip move upwards too much and hard to move my lip downward!

Question

i had total of 10unit of botox on my chin. the sites that doctor injected was blue points in the last photo. when i did with same doctor last year, it went good. please see photos. but this time i feel the muscle under the bottom lip is in tense and pushing the bottom lip upward and to center. i feel uncomfortable and tired to talk especially when smiling and talk. should i add more botox? if so, where should be injected? will injecting on the red points in the photo help or make it worse?

Matthew Richardson, MD · Answer

First, any concerns over a recent injection should definitely be discussed in person with the person who performed the injections. 
Botox around the mouth should only be performed by an experienced and highly-qualified injector as complications can and do occur. Botox works by weakening the muscles in a given area, so any weakness to the muscles around the mouth can lead to functional issues such as trouble smiling or talking. Generally, if problems arise, the answer is not to add more Botox but to let the Botox that has been injected wear off. As always, a visit with a board-certified physician who is an experienced injector is recommended.

Svetlana M. Danovich, MD, PhD, FACS · Answer

Care must be taken when injecting Botox in the chin area and too much Botox( typically 4-8 units are used) may cause asymmetric smile due to spreading Botox to adjacent muscle. I think you got too much of Botox. You DEFINITELY do not need more Botox at this time."Feeling  uncomfortable and tired to talk especially when smiling" will go away in 3-4 weeks , this overwhelming effect is temporary.

Melvin Elson, MD · Answer

It looks like it was injected a bit high and that is why the lip went up. Let this go away which will take a few weeks and then if you want have injections a little lower

Tarek M. Fakhouri, MD · Answer

Botox in the chin and help to relax the muscle of the chin and elongate the appearance of the chin. However, too much botox can also affect the lip muscles. It appears that you are having some weakness in your lips. If you add more botox this uncomfortable feeling can increase. I recommend being patient and waiting for the botox on the lip to start to wear off. You will start to feel better in the next few weeks.
Take care!
Tarek

Glenn Messina, MD · Answer

The injections were given to central and should have been lateral to the lower dots closer to an imaginary line drawn from the NL folds at the side of your mouth. In this area the lip depressor was blocked so yet the lower lip will raise in invert a bit. Unfortunately nothing you can do but wait. It will resolve in about 3 months.

Christine Eros, MD · Answer

Hi. It seems that some of the Botox was inadvertently placed in the little muscle next to the chin muscle that moves the lip downward. I would recommend just waiting for the Botox to resolve and do not have any further Botox placed at this time.  The nice thing about Botox is that the affects resolve completely after 3 months. Good Luck.

Somyos Kunachak, MD - Account Suspended · Answer

Hi m222, Based from your photos and your description, it is most likely that the botox hit the muscle that is responsible for pulling your lips down, making your lips pout upwards by the counteracting muscle. To correct this, botox injection can be aimed at the point closer to the middle of  the chin (and deep), in order to reduce the strength of the counter acting muscle, or you can just wait a few months for the effect of the botox to wear off.

Botox on chin made my bottom lip move upwards too much and hard to move my lip downward!

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