Numbness Normal After Botox?

Question

I got Botox in my forehead, between and under my eyes. This was my first time. This is my second day and my cheek and lip feel numb. Is this normal?!

Jerome Edelstein, MD · Answer

This is normal. Swelling, numbness, discomfort and possibly bruising during the first few days following the injection is common. Most of this settles down within 3 days. Occasionally, the swelling can last up to one week, as well as bruising.

Trevor M. Born, MD · Answer

Dear SBDTRflygl
The changes in sensation in the area you are describing are not normal. Do you have a bruise? Are there any bumps or a rash like pattern on your cheek?  
You can have odd sensation changes- usually in the eyebrow area- particularly if you are trying to frown- but day 2 is early for that.  You also can have some lip numbness if the botox is  injected into the lips directly- this will be apparent in the first week after injection and will resolve by 2 weeks.  Again day 2 is early,
Please follow up with your MD.
With Warm Regards,
Trevor M Born MD

Kenneth D. Steinsapir, MD · Answer

Dear Sdbtrflygrl
For your first time treatment, it is normal for have a variety of sensations was the BOTOX is first taking effect.  Occasionally it is described as numbness.  However, what you are describing is entirely different.
The cheek and upper lid numbness could be associated with a bruise to the sensory nerve that supplies this area.  What is strange is that there is no reason for BOTOX to be injected deep enough to effect this nerve.  
Did your doctor inject your cheek with local anesthetic before doing your BOTOX treatment?  This could have bruised the nerve.  These types of injuries generally recover very quickly and are unlikely to persist for more than a week.
The best advice is to contact your doctor's office and be seen by the doctor so he/she can address your concerns.

Michael A. Persky, MD · Answer

Hi sd...grl,

Numbness of the cheek and lip are not normal after Botox injections. Contact your injecting physician for an evaluation.

Some of the Botox injected under your eye may have affected the muscles of the cheek (some of which help to elevate the upper lip). You may be interpreting the muscle weakness as numbness.

The other possibility is that the needle may have traumatized the infra-orbital nerve giving you temporary numbness.

I hope that your symptoms resolve soon, but see your doctor.

Dr. P

Christopher L. Hess, MD · Answer

Numbness after Botox is not normal.  Botox is a paralytic acting on the nerves that connect to muscles.  It prevents the release of the neuro transmitter the goes to the muscle telling it to move.  The numbness that you are describing encompasses the area of the face supplied by the infraorbital nerve.  This nerve emerges from the facial bones just below the lower orbital rim in the center.  You can usually feel where it is by pressing in this area.  You will have more pain when you're directly over the never. 
You state that you had Botox under your eyes.  If the Botox was injected into the nerve this will paralyze the sensory nerve to the cheek and lip.  Unfortunately, it may not wear off for several months and there's really nothing you can do about it.

Bryan K. Chen, MD · Answer

Numbness after Botox is not normal.  Botox is not typically injected deep enough to affect significant sensory nerves of the skin.  Perhaps you received an infraorbital nerve block which stunned that nerve??  This would explain the numbness of the cheeks and upper lip.  I would contact your treating physician to discuss your concerns.
Good luck.

Scott E. Kasden, MD, FACS · Answer

The needle may have bruised a nerve going to that skin during the injection.  It should self correct in a few days. This is rare, but it happens.
sek

Francisco Canales, MD · Answer

Hello
It is not normal to have numbness in the cheek and upper lip after Botox.  Your numbness sounds like it is following the distribution of the infraorbital nerve.  Two possibilities:
1. Swelling around the nerve could temporarily cause numbness.
2. The needle could have temporarily injured the nerve.
 
In either case, please return to your doctor and make sure he/she is aware of what your symptoms are.  Hopefully, the reaction is temporary and your feeling will return soon.

Numbness Normal After Botox?

Answers (8)

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