How Long Before Asymmetry from Botox Gets Corrected?

Question

I am a little over 14 weeks post-op from a bad Botox outcome, which caused brow asymmetry.  In just the past few days, I think I am finally noticing some minor improvement, but the change is extremely subtle -- and I hope what I'm noticing isn't simply wishful thinking. When the effects of the Botox wear off, how long does it usually take for this type of asymmetry to fully correct?

Ron Shelton, MD · Answer

When the Botox is fully worn off, when you can actually move the forehead fully, the asymmetry should be gone at that time. It’s not unusual to see symmetry redevelop before the lines come back. You are probably very close to seeing your normal appearance. Be patient, it’s coming.

Kenneth D. Steinsapir, MD · Answer

Dear Fran
BOTOX typically lasts about 4 months.  There can be a slightly longer duration from muscle retraining.  However at this point the medication is no longer effective.  This would be a good time to consider retreatment.  
Of course the key is find someone you have confidence in and knows what they are doing.  An experienced injector should be able to adjust your treatment to account for your asymmetries.
Dr. Steinsapir

Eric M. Joseph, MD · Answer

Dear Fran,
You should have near complete mobility of your forehead very soon. The most common "bad" outcome from BOTOX in the forehead is slight brow-drop that makes your upper eyelid skin bothersome.
It will all completely go back to it's pre-injection condition shortly, so sit tight for another couple of weeks.
Best regards.

Mary P. Lupo, MD · Answer

For future reference, Botox should be corrected at about 2 weeks. Slight differences in muscle strength can result in asymmetry, but it is easily corrected by a touch-up. You should not even have a charge for this service, since it is a correction. Go to an experienced, appropriately board certified doctor next time who knows how to give you a perfect effect from Botox.

Bryan K. Chen, MD · Answer

The asymmetry you are experiencing should resolve within 4 months from the time of injection.  In the future, you might want to address any asymmetries with your treating physician 2 weeks after your Botox injections (when the treatment takes full effect).
Good luck.

Edmond A. Zingaro, MD · Answer

At 3 months Botox begins to wear off. You are starting to see that. By 4 months it is generally gone and that is when patients come for reinjection. I expect you will see return to pre-Botox conditions within the next month.

Arnold R. Oppenheim, MD (retired) · Answer

Some of these adjustments can be very easily corrected so I would recommend returning to the physician who injected you. Oftentimes, patients do not know how easily this can be done.
    For instance, I had a patient who wanted the right brow to match the left. The dilfference was subtle but it was there. One unit into a lateral brow lift and she was pleased.
   A "spoci" is always relatively common and easily recitilfed. This occurs when the strong central part of the frontalis is relaxed (paralyzed) but the area that curves around is not. When the patient lifts her brow the central part fails to lift since it has been knocked out but the lateral part lifts since the muscle has not been deactivated in this area. One to two units of Botox above the "Spock" fixes the problem.
   Otherwise, if you see that the Botox affect is beginning to wear off, I suspect that it will be fine in a week or two. At any rate, Botox affect dissipates usually in three months...four at the max.

How Long Before Asymmetry from Botox Gets Corrected?

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