Botox for Dent Left After Cleft Lip Surgery?

Yesterday, I got Botox injected on my upper lip. This morning, I woke up and it was swollen. Is this the effect? I was born with a cleft lip, and due to that, as a child, it has left me a dent after surgery. I figure Botox would fill in the small dent, but it just made it more noticeable. Will the swelling come down after a few days? What may help?

Doctor Answers 3

Botox may have been the incorect "fix" for lip dent after cleft surgery.

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If in fact you have a nicely repaired cleft, the muscle was reoriented and repaired, along with the surface skin repair. Residual contour deformity (dent) could be a natural occurence after any cleft repair, and one of several fillers could (temporarily) improve this. If indeed the muscle is "bunched up," Botox may have been deemed appropriate, and rightfully used, but this too is temporary.

An experienced, board-certified plastic surgeon, ENT, facial plastic surgeon, or pediatric surgeon who does cleft surgery on a regular basis, should evaluate your lip to see if surgical revision can permanently improve your present result. I know many patients prefer fillers or Botox because these are non-surgical, but eventually you end up spending more than you would on an excellent surgical revision. Best wishes!

Minneapolis Plastic Surgeon
4.9 out of 5 stars 263 reviews

Are you sure botox was injected, or could it have been a filler?

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Are you sure that Botox was injected to fill in the dent? Or is it possible that a filler such as Restylane or Juvederm was injected? Botox is used to relax muscle contraction not to fill things in. If the muscle was bunched up, then Botox may have been injected into the bunched muscle, but not into the "dent".

Botox is used on occasion in the lips to soften lip lines caused by overaction of the muscles. These are commonly referred to as "smoker's lines" and are visible when the lips are pursed, such as when drinking through a straw or whistling. Since you had cleft lip repair, it is not uncommon to have irregularities in the contour of the lip but probably not the so-called smoker's lines.

Perhaps you can call the office where you had your treatment and confirm that it was indeed Botox or find out what exactly they injected and then we can better help you. Or, if you can post pictures, that would help too.

Jonathan Hoenig, MD
Beverly Hills Oculoplastic Surgeon

Swelling of lip after Botox to cleft lip

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Botox is not a filler. In most instances it either causes muscles to relax or become smaller in size. The findings you describe puzzle me. Perhaps a small blood vessel was hit and you are experiencing swelling that will resolve in a few days, Alternatively, it could be due to a relaxed muscle and in this case it could last for 3-5 months before the swelling would dissipate.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 86 reviews

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