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?

Question

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?

Sanusi Umar, MD · Answer

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&rsquo;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.

Ron Shelton, MD · Answer

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.

Ken Landow, MD · Answer

not doing anything..botox may work well in these instances but it often may be more than the lips that need treatment...it 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

Michael Bowman, MD · Answer

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!

Robert L. Kraft, MD, FACS · Answer

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.

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?

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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?

Answers (8)

Answer: Botox For the Upper Lip

Answer: Botox For the Upper Lip

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

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

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

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

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Everything you need to know about Botox

Answer: Be careful with Botox around the mouth

Answer: Be careful with Botox around the mouth

Answer: Lip puckering

Answer: Lip puckering

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Our mission is to create a world where every investment in modern beauty is Worth It.