Distorted face when I laugh after I get Botox - is this normal?

Question

Over the years I have tried botox four times, minimal amount to crows feet-one drop under each eye, 5 units per eye & I do 10 units to my 11s.... Every. Single. Time. I feel my face distort in a weird way when I laugh after doing botox.. two of the four times my posed/practiced smile looked fine (the other two times my smile was iffy) but when I laughed I could feel my face twist strangely/crooked-no clue what I looked like though when laughing- is this normal??

Jeffrey Lisiecki, MD · Answer

Tough to say based on just a description, but if the botox was not injected symmetrically, you may have had different activity between sides of the face. Alternatively, sometimes other muscles get more active when you weaken some muscles (like bunny lines that show up worse after the glabella and crows feet are injected). This may be more with spontaneous movements like laughing than with practiced movements in the mirror. You should be seen by an experienced injector and evaluated to see how your face moves to determine the best plan for your botox injections.

Jonathan Kulbersh, MD · Answer

Thank you for your question. Risks from Botox Cosmetic should be minimal when performed by a qualified injector. I recommend scheduling an in-person consultation with an experienced, board-certified facial plastic surgeon who can assess your dosage and perhaps suggest a more favorable injection site. Addressing these two factors may alleviate the distorted facial expression you describe.

Andrew M. Ress, MD · Answer

It is possible to have a distorted smile after treating your crow's feet with Botox if too many units are injected or if the injector placed the Botox too low towards your cheek. This can be prevented by going to an experienced injector or by not having Botox on your crow's feet.

Geeta Yadav, MD · Answer

Thank you for your question! It’s important to note that Botox takes time to “kick in.” It takes up to a month for the final results of Botox treatment to be visible, but many providers recommend booking a follow-up appointment at the two-week mark. It’s very important to book your follow-up appointment &mdash; it allows you to express your concerns and your provider to assess your outcome and determine if any adjustments need to be made. Hope this helps!

Camille Cash, MD · Answer

I'm sorry you are having issues after your Botox treatment.  It's best to wait for 2 weeks after treatment in order to see your final result.  If at that time you have concerns, return to your injector for an evaluation.  Any adjustments can be made for current or future treatments.

Rita Rakus, MBBS - Account Suspended · Answer

Hello and thank you for your question. It is always best to see you face to face for a consult and examination however in this case it doesn't sound like a positive result and we would suggest you speaking to your injector as it is likely to be the botox injection sites or dose. I hope that helps answer your question. Always seek an experienced and qualified medical professional for these treatments. Very best wishes

Distorted face when I laugh after I get Botox - is this normal?

Answers (6)