Flattened Lips After Botox

Plastic surgeon in Temecula zapped a vertical wrinkle below my lower lip with Botox.

Now 4 days later, the wrinkle is almost gone and so are my looks as that portion of my lip seems to have flattened out (I have naturally thick lips). Now my mouth looks asymmetric. Help!!!

Please advise on what would be the best course to fix this. Maybe injecting filler as I could not bear to take chances with the other side of my lower lip?


Doctor Answers 4

Botox relaxes muscles

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Botox relaxes muscles. It does not fill in wrinkles. When Botox is used on the lips, the orbicularis muscle (the circular muscle that surrounds the mouth) relaxes in areas where the Botox was injected. This reduction in muscle activity can result in a flat appearance or reduction in function of the orbicularis muscle.

Rather than injecting the opposite side and ending up drooling or speaking funny, you may want to let the Botox go away, then use a hyaluronic acid filler like Juvederm to reduce the lip wrinkle.

Also an option is laser resurfacing if the lip lines are due to sun damage.

Last, smoking and sun contribute greatly to the formation of lip lines, so avoiding these will minimize the development or worsening of lip lines.

Beverly Hills Plastic Surgeon
4.9 out of 5 stars 195 reviews

My advice is don't do anything for 3 or 4 months.

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Hi! Using Botox in the lower face is much trickier than around the forehead and eyebrows. There is no margin for error and you only need tiny doses (2 or 3 units for the line you are describing).

Trying to fix this now could easily leave you with a new, longer lasting problem. So try to be patient.

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon

Flattened lip after botox

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It may be best to wait until the effects of the Botox injection wear off. Injection of Botox to the other side of the lower lip would also flatten out that side - probably not the symmetry you would be looking for. You may want to find out how many units were injected to that wrinkle for reference. Filler injection may be an option to help correct that vertical wrinkle in the lip in the future.

Good luck.

Bryan K. Chen, MD
San Diego Dermatologist

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Be cautious the solution may be worse than the Botox problem

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You have to be careful with this. Most fillers will last beyond the time of the Botox and then you will have caused a different problem. I would generally advise waiting until the botox wears off. IF you are intent on using a filler, I would consider a short term filler such as Prevelle silk.

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

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.