Botox Induced Cheek Ptosis? Please Tell Me This Will Go Away?

I had botox 1 week ago and noticed that my plastic surgeon injected it further below my eye (instead of just along the outer corners) below the iris. I believe this has caused cheek ptosis as I see that when I smile my cheeks protrude in a strange way and seemingly lower on my face. I naturally have bigger cheek pads so this exaggerates the effect. Will the natural movement of my face return with time? Is this due injecting in the wrong area?

Doctor Answers 5

Botox Induced Cheek Ptosis? Please Tell Me This Will Go Away?

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 The good news is that the effects of Botox injections eventually go away.  Movement, in the effected muscles, can begin to return at 6-8 weeks and should be fully functional at 3-4 months.  Contracting the facial muscles can accelerate the process somewhat.  Hope this helps.  Best to keep the Botox in areas that will not result in sagging of the face. 

Beverly Hills Facial Plastic Surgeon
4.7 out of 5 stars 28 reviews

Untoward side effect

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If you have a side effect from Botox injection than it will most likely resolve on its own within anywhere from one to three months depending upon the side effect.

I would recommend injection only by a properly licensed board certified dermatologist or plastic surgeon.

Steven Hacker, MD
West Palm Beach Dermatologic Surgeon

Botox Injections Around the Eyes

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Unfortunately this has happened to you but fortunately this will go away when the Botox wears off.  Most likely the Botox was injected to low (pass the eye muscles) and into the upper cheek muscles.  I tend to also inject lower units of Botox in the lower parts of the eye muscles to avoid this temporary complication.  Botox  can diffuse 1-2 cm away from the points on injection. Don't give up on Botox.  It is still one of the best ways to get rid of smile lines.  

Mary Pentel, MD
Jacksonville Dermatologist
3.7 out of 5 stars 11 reviews

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Botox Injections Below the Eye

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Hi Houston.  What you are describing is not normally what we see in cases where a patient has been injected below the eye.  If your injector comes further down below the crow's feet or even below the eye, we normally see a relaxation of the circular muscle that surrounds the eye, causing a puffy or baggy appearance in the tear trough area below the eye.  We would encourage you to check the before pictures to make sure it's nothing else, but normally the cheeks don't move downward after Botox injections.  Good luck.

Harold J. Kaplan, MD
Los Angeles Facial Plastic Surgeon
4.4 out of 5 stars 7 reviews


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Yes, your smile will return back to normal, however, it may take 3 to 4 months.  Luckily Botox is not permanent. 

Grant Stevens, MD
Los Angeles Plastic Surgeon
4.7 out of 5 stars 152 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.