Side of Face is Paralyzed After Botox for Crow's Feet

Question

I had botox for crow's feet and now the right side of my face is paralzed. Will this get better? 6 days after botox the right side of my face felt numb. When I smile my mouth pulls down severely on the right. My doc said she believes the botox migrated to the nerve in my cheek and will be fine in a few weeks. Have you ever seen this before and is it reversible?

Babak Azizzadeh, MD · Answer

Thanks for your question. I’m sorry to hear that you are going through this. The good news is that the effects of Botox are temporary, so they will start to wear off 2-3 months after treatment. Botox works by limiting movement of the muscles that create wrinkles, and if too many units were used, it may have caused the drooping that you are experiencing near your mouth. With that being said, the numbness that you are describing isn’t explained by the Botox. Your Botox treatment would not have any effect on the nerves that control feeling. I would recommend that you see your injecting physician for a follow up appointment as soon as possible, and if the numbness continues schedule an appointment with your primary care physician for a thorough assessment. Good luck!

Christopher V. Pelletiere, MD · Answer

As previous doctore have mentioned, Botox does not effect the nerves themselves, but rather the muscles. If you experienced some facial paralysis from the botox, then either your physician injected you in the wrong areas, injected you too deeply, or the botox migrated into those muscles. If it is some migration, the effect will wear off in a few weeks. If you physician injected you in the wrong area or too deeply, then the effect will last as long as the Botox is around - 3-4 months. I would discuss this with your physican in more detail.

Otto Joseph Placik, MD · Answer

Your symptoms don't make sense. Botox does not make nerves numb unless the nerves are injected directly and that is very deeply. Botox interferes with nerves that move muscles and not nerves that allow you to feel

Ron Shelton, MD · Answer

Your doctor may be right about the Botox having affected one of the smile muscles on that side of the face.fortunately this is always temporary. The nerves that allow us to feel sensation and those that make muscles move are different and so the numbness is not explained based on the Botox.

Michael A. Persky, MD · Answer

Hi,

	Botox works in muscles, not nerves.  This should not occur, though we have heard of it happening. Too much Botox was put in the wrong place.

	You should be evaluated by an expert in Botox and the facial nerves.  Make sure that you did not develop a coincidental case of Bell's Palsy that can be treated with steroid. 

	I hope that your symptoms resolve sooner than later.

	Good luck and be well.

	Dr. P

Side of Face is Paralyzed After Botox for Crow's Feet

Answers (7)