Can Botox Help Sternocleidomastoid Spasms After Facelift?

Question

Ever since a mini-lower face and neck lift 5 months ago, I've had intermittent tightness and spasms of the SCM muscle on one side. It also causes a tight, plugged-up feeling in the ear on that side. I'm receiving regular massages from a therapist but progress is slow. Would an injection of botox help calm the SCM down? Are there any risks? The ps who performed the surgery doesn't like the idea but a ps I saw for a 2nd opinion thinks it's a viable option. Thank you for your opinion.

Nima Shemirani, MD · Answer

Dear Carol99,

	
		To see if Botox would work, you can try local anesthetic, maybe something longer acting (8-12 hours) like Marcaine (bupivicaine)
	
		Local anesthetic can act like a short term Botox to relax muscles
	
		This would give you a little window to see if Botox would work before committing yourself to the cost and 3 months of potential side effects


	Best regards,

	Nima Shemirani

Kenneth Hughes, MD · Answer

Botox or one of its variants has been used to treat cervical dystonia or spasmodic torticollis for years.  This may have applicability in your case.

Adam David Lowenstein, MD, FACS · Answer

Occasional patients can experience irritation of muscles following facelifts and these issue nearly always resolve with time. If the spasms continue to be problematic, some Botox can be helpful. Make sure your surgeon is familiar with this treatment, but know that over time, this will VERY likely get better on its own.

W. Tracy Hankins, MD · Answer

Botox is commonly used for muscle spasms and in fact had therapeutic indication for this prior to its cosmetic approval. This is a fairly easy injection and may well help - I have injected this area in several patients for spasm after they were involved in a MVA with good results. The only "common" side effect at the doses you would need for this would be a possible weakness that you would notice on the side of the injection, but none of the patients I have injected have noticed this.

John Q. Cook, MD · Answer

Yikes! I'd be careful with this idea if I were you. The doses that neurologists use to soften the activity of major muscles are much greater than we use in the delicate muscles of facial expression. With greater dosages come greater (and much more serious) complications. I'd be inclined to try gentler methods.

Can Botox Help Sternocleidomastoid Spasms After Facelift?

Answers (5)