Does Botox Affect Smile?

I want to get Botox on my lower face but will I be able to still smile? I have had Restylane but was not happy with the results. Would Botox give a better effect?

Doctor Answers 6

Botox does effect the smile but it depends on where you put it

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Botox can be used to effect the smile intentionally.

For example, when people present with a "gummy" smile, we use Botox to drop the upper lip and prevent the excessive gum show. It is injected into the levator labii superioris alaeque nasi.

Alternatively, some people have excessive downturning or pulling down of the corner of the mouth with smiling. In this instance, we inject it into the depressor anguili oris muscle to allow the corner to lift with smiling.

Depending on where it is placed, Botox can have desired or undesired effects.

Generally the effects achieved with Botox are different than those accomplished with fillers

Chicago Plastic Surgeon
4.9 out of 5 stars 86 reviews

Botox may or may not affect your smile

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Botox is injected around the mouth to improve downturning and pulling down of the corners of the lips, and also to improve the orange peel look of the chin as well as to improve the vertical wrinkles of the lips.

If not injected well it can cause drooping of the lips and this may take up to 6 months to return to normal.

It is much safer to use fillers to improve this area.

Nissan Pilest, MD
Irvine Dermatologic Surgeon
4.6 out of 5 stars 23 reviews

Botox in the muscles around the mouth can lead to a lip droop

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There is a very small safety margin of safety while injecting Botox in the muscles that lift the corners of the mouth when smiling to decrease the smile folds. There could be a lip droop such that it looks like the effect of a stroke or there could be drooling or difficulty speaking or eating. This should be done only by a very experienced injector of Botox. There are other fillers that might work better for you such as Juverderm Ultra Plus or Perlane or Radiesse.

Ronald Shelton, MD
Manhattan Dermatologic Surgeon
4.9 out of 5 stars 39 reviews

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Botox and the Smile...When You Smile the World Smiles With You...

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Hi LuLu,
Botox in the lower face is used in the depressor of the corner of the mouth to make the corners look happy. It is used in the chin to correct that orange peel texture, and it is used in the upper lip to decrease vertical lines. It may also be used to correct a "gummy" smile, and in some patients to lift the tip of the nose.

It can affect your smile both positively and adversely (if improperly placed). The use of Botox in the lower face requires a good knowledge of the muscle anatomy and function. In this area choose your injector most carefully.

Remember, when you smile, the world smiles with you, but when you drool or can't smile, the world knows that you have had "bad Botox" for 3 to 5 months.

Good luck and be well.

Dr. P

Michael A. Persky, MD
Encino Facial Plastic Surgeon
4.8 out of 5 stars 39 reviews

Botox - Limited Uses on Lower face. Not for smiles.

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Botox has only a few uses on the lower face. If you have a down-turned smile Botox can be placed into the DOA muscles and this will put the mouth into a stright line. It is also used to give a small pout to the lips and is good in this way for smoker's lines.

However, Botox is not very effective for making a smile. In fact, if Botox is not administered properly it can affect the smile, but in a bad way.

Fillers are much better in this area. If you did not have success with Restylane you might seek a different filler such as Evolence, a collagen filler or the semi-permanent filler Radiesse. Good luck.

Arnold R. Oppenheim, MD
Virginia Beach Dermatologist

Not common

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Where do you want the Botox in the lower face?  In my experience this is not common.  If you are interested in treating the nasolabial folds, Botox will not work.  I have found it is good for the lipstick bleed lines however.


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.