Botox in the Upper Lip Wasn't Effective All over and Didn't Last Long. Should I Have More Injections and Have Them Once a Month?

My lips purse quite a lot when I speak and even when I'm not doing anything. My mouth is getting more drawn in and I'd like to break this habit as even at rest I'm getting indentations from these muscle movements. When I last had botox there the injector only injected a tiny amount in one or 2 creases. But I have 3 big creases on each side of my lip. Also, the botox didn't last long Should I have 6 botox inections in each of the 6 creases in my lip? Should I have these injections every month?

Doctor Answers 8

Sounds like you have a tic issue or perhaps a facial spasm if your lips purse when you're

not doing anything..botox may work well in these instances but it often may be more than the lips that need may carryover into the cheeks...ask your doctor to consider whether this may be the problem...if just the lips are the problem, then you have to understand that too much botox may interfere with your ability to enunciate and keep food/beverage in your mouth...for these reasons only a small amount of botox is advisable...but if you wait for two weeks, you can go back to your doctor and get some more...and then there's always a filler or laser to consider as additive therapy...good luck with your quest

Las Vegas Dermatologist
4.6 out of 5 stars 9 reviews

Botox For the Upper Lip

Botox is usually injected to address the formation of horizontal forehead lines, crows feet and glabella frown lines. However it is not an ideal solution to treat wrinkles around the lips, especially since mouth muscles are needed to perform a lot of different functions. There are other dermal injections that don’t target the muscles, but fill in the wrinkles instead. Radiesse is a filler that helps your skin actually synthesize new collagen in addition to filling in the creases. Also in some cases, Fraxel laser can be successful for the treatment of lip wrinkles. This also works by enabling your skin to create new collagen as well.

Sanusi Umar, MD
Redondo Beach Dermatologic Surgeon
4.6 out of 5 stars 32 reviews

Botox for the vertical "smoker's" lines of the lips

Botox can be used off-label by physicians to minimize the lip lines, sometimes referred to as smokers lines.  The muscle of the lip is circular around the mouth and relaxing it with botox will accomlish less pleating of the overlying skin during speech. Usually very few units are used, 1 to 2 units per site and only a couple of sites per lip. As you try to improve the aesthetic result you run the risk of flattening the lip too much so that you have problems enunciating all letters, opening to speak correctly and affecting your smile (not showing your upper teeth), have problems brushing your teeth and dribbling when trying to drink from a glass or straw.  Fortunately these are not permanent side effects, and go away when the botox wears off (four months or so). For these reasons, the doctor needs to be conservative and 6 injections in each lip, depending on the dilution, volume and units used, may be too much.

Ronald Shelton, MD
Manhattan Dermatologic Surgeon
4.9 out of 5 stars 38 reviews

Botox in the Upper Lip Wasn't Effective All over and Didn't Last Long. Should I Have More Injections and Have Them Once a Month?

  I have used Botox and the newer Dysport and Xeomin to reduce lines around the lips and mouth for over 22 years.  Use of neurotoxins, in this area IMHO, requires a conservative approach so the lines are softened but the patient can still use thier lips in the proper manner.  Perhaps the dose needs to be adjusted and once you find the right MD to do this, a series of treatments at 3 month intervals would be suggested IMO.  

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.6 out of 5 stars 25 reviews

Botox effectiveness in upper lip is variable

in my experience, the impact of botox for vertical upper lip furrows is variable. when it works, it's great but when it doesn't, one must resist  the temptation to use more, lest three months of problems with function result.

 other options that may help include fillers like juvederm, dermabrasion, and deeper chemical peels.

Bruce K. Barach, MD
Schenectady Plastic Surgeon
4.6 out of 5 stars 13 reviews

Be careful with Botox around the mouth

Botulinum toxin use around the mouth is effective must be done with caution.  Too much medicine in this area can lead to very noticeable problems:  drooling, asymmetric smile, etc.  These problems will stick around until the medicine wears off in 3-5 months!  

It is possible to get good results with the botox around the mouth, but you can't over do it. Make sure you are seeing an experienced injector.  If you are not, or you aren't sure, seek a second opinion.  

If the creases around your mouth are particularly stubborn, the answer is probably not more Botox, but more likely some other treatment.  Dermal fillers (Juvederm, Restylane, etc) may be helpful or perhaps a laser treatment or peel may help address the areas in question.  Your physician should be able to give you a very clear plan for how to address your concerns.  

Finally, if you are a smoker, you need to stop.  Many patients spend hundreds of dollars trying to undo the damage done by their bad habit.  Best Wishes!

Michael Bowman, MD
Roanoke Facial Plastic Surgeon
5.0 out of 5 stars 10 reviews

Botox in the lips can be difficult

This is tough without a photo, but I would say this: injecting Botox into the mouth area needs to be done by extremely experienced injectors only. Injecting too much, or too often, or into the wrong spot can result in the mouth or lips not functioning properly, which will affect your speech, eating, and can even just drop the lips so you cannot move them. I do not recommend more for you, but rather, a consultation with a board-certified dermatologist or plastic surgeon to assess what you have going on and see if perhaps fillers would be a better option. Monthly injections should absolutely not be considered without further assessment.

F. Victor Rueckl, MD
Las Vegas Dermatologist
4.6 out of 5 stars 17 reviews

Lip puckering

It's impossible to evaluate your problem without a photograph. Botox should last for up to six month if injected properly and in an appropriate amount. Subclinical treatment will not be effective. If you are a smoker and have wrinkling as a result, then I would encourage you to quit as this contributes to formation and deepening of lip wrinkling and early aging.

Robert L. Kraft, MD, FACS
New York Plastic Surgeon
5.0 out of 5 stars 42 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.