Botox Crooked Smile

I got botox around my mouth and it caused a crooked smile. Is there a way to fix this?

Doctor Answers 8

In the future, Do Not let anyone inject Botox around your mouth


Botox works by paralyzing muscles. This effect is beneficial in the forehead and around the eyes (crow's feet area) to reduce wrinkles caused by dynamic muscles. The muscles in your cheeks and around your mouth have very important functions in chewing and talking. While it is tempting to inject Botox in the upper lip and jowel area, it really serves no purpose. Most of the wrinkles in lip and around the mouth are static - that is, they are present even when the muscle is not contracting. These wrinkles require resurfacing to smooth them out or fillers from below to fill the defect. Now that you have had Botox injected around the mouth and you are suffering the dreaded temporary complication, the only way to help is to try and restore the balance of the muscles. This may be helped by injecting Botox on the other side to help restore symmetry or in an opposing muscle. In any case, you should talk about all of these issues with your doctor and make sure that only experienced people are injecting your Botox.

I hope this was helpful.

David Shafer, MD
Shafer Plastic Surgery
New York City

New York Plastic Surgeon
4.9 out of 5 stars 75 reviews

Smile - it will get better

Greetings Suzanne,

I would definitely agree with Dr. Persky on all points. You may be able to have the opposite side injected to even out the smile. In the alternative take heart - this will resolve on its own and you should notice some motion in probably a month or two.

D.J. Verret, MD
Dallas Facial Plastic Surgeon
3.9 out of 5 stars 14 reviews

Botox mouth distortion will get better on its own.


Either you got too much Botox, or it was not injected in the right place.  Time is the best cure.  In about 4 months, everything should be normal.

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon
4.8 out of 5 stars 9 reviews

Botox Correction

Hi Suzanne,

I would return to the physician who treated you. After examining your peri-oral muscles and their movement, it would be possible to determine whether a small additional Botox would "even out" your smile. I'm sorry that you are having problems, but this again emphasizes the importance of having an experienced physician with knowledge of the underlying muscles performing Botox injections. This is a medical procedure. Be well and hopefully a quick recovery of your beautiful smile.

Dr. P

Michael A. Persky, MD
Encino Facial Plastic Surgeon
4.8 out of 5 stars 36 reviews

Botox crooked smile

Sorry to hear about your experience with Botox. Fortunately, Botox is not permanent and you should be back to normal in a few months after your treatment. You may even see an improvement sooner. You could consider getting another Botox treatment to even out your smile.

Jerome Edelstein, MD
Toronto Plastic Surgeon
5.0 out of 5 stars 176 reviews

Botox Crooked Smile

Sorry to hear about your experience. Time is the best healer, and you will need 4 months although you may notice some improvement sooner.  Your experience further demonstrates the need for an experienced and expert injector.

Kris M. Reddy, MD, FACS
West Palm Beach Plastic Surgeon
4.4 out of 5 stars 41 reviews

Boto and crooked smile

Unfortunately, there are some infrequent side effects with BOTOX such as that which you've experienced. Botox and its effects resolve in approximately 4 months, but I find side effects such as this resolve after about 2 months. I would encourage using the smiling muscles to get it to break down faster. Injecting a little Botox on the opposite side of the problem can even out the smile in the meantime.

Benjamin Barankin, MD, FRCPC
Toronto Dermatologic Surgeon
4.8 out of 5 stars 50 reviews

Botox for crooked smile

Most likely, Botox will be able to help fix the problem you are encountering. We would suggest returning to your physician to show him/her the problem and get their thoughts on the situation. If the physician is very confident that he/she can fix the problem, then it may be worth letting them try. If they seem to be having second thoughts, it may make sense to look for an alternative practitioner for the corrective work or to wait several weeks to a couple months for the Botox to wear off (it wears off more quickly around the mouth because of the excessive movement).

Harold J. Kaplan, MD
Los Angeles Facial Plastic Surgeon
4.3 out of 5 stars 6 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.