Can I get Botox in my levator labii superioris muscle so I don't get these dimples when I squint/laugh/smile strongly? (Photo)

Question

When I smile I get dimples like this on both sides of my face and they bother me tremendously. If I smile gently and try not to let my cheeks go up they're not there. I am wondering if I can get Botox injected in my levator labii superioris muscle so that I can smile strongly as I usually do without the dimples appearing. If I do this will my mouth/smile freeze or look deformed? Thanks!

Nelson Lee Novick, MD · Answer

Botox affects muscular movement, and as such runs the risk in the case of giving rise to an abnormal smile or to an inability to smile properly. Additional photos, especially of one full face at rest and full-face upon smiling would have been very helpful. Generally speaking, this kind of indentation, as well as the prominent nasal fold seen, arises from a loss of volume with the passage of time is not so uncommon and can be improved via the skillful use of an appropriate HA filler in order to create a more pleasing smooth transition between the upper cheek and the lower eyelid region. Secondarily, this kind of treatment will likely improve somewhat the smile fold without even the need to directly inject this region, which if done, particularly by novice injectors, often leads to a puffy, chipmunk-like look. You would be wise to consult with a board certified cosmetic dermatologist and be sure to ask to see his/her personal before and after photos before agreeing to proceed. Best of luck.

Jason Emer, MD · Answer

Botox can be injected into these areas to create a softer look. The botox will essentially relax the muscles creating the appearance of atrophic muscles. The results will last up to 3-4 months hence you will have to re-inject roughly 3x per year. When administered by an expert injector you shouldn't have an issue with too much laxity. The biggest issue will be muscle weakness if you inject too large doses, which will be required in larger muscles (as compared to cosmetic forehead/face injections) See an expert. Best, Dr. Emer.

Martie Gidon, MD, FRCPC, FAAD · Answer

Botox is not indicated for the depressions you develop when smiling or squinting. Sagging and loss of volume need to be addressed with fillers. Please consult an experienced dermatologist for assessment of the best placement of fillers for you.

Robert T. Buchanan, MD (retired) · Answer

The "dimple" you show is from a variant of the orbital ligament where the medial portion goes down the cheek giving you a second depression above the nasolabial fold. Treating the levator labii superiorus will negatively effect your lip function and smile. What you need is a filler done by an expert in treating this area. Be careful in your selection, as most do not understand the deep structures in this area.

Can I get Botox in my levator labii superioris muscle so I don't get these dimples when I squint/laugh/smile strongly? (Photo)

Answers (4)

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