Will Botox Re-trigger Bell's Palsy?

Question

I am thinking of having botox or a similar treatment to smooth out forehead wrinkles. I am 49 years old. When I was 19 I had Bell's Palsy and it has never 100% repaired itself, although most people tell me they wouldn't have noticed it. I am worried that botox etc could re-trigger the Bell's palsy - particularly as some people I've seen who have had such treatments appear to be prone to droopy eyelids.

Jeff Markey, MD, FACS · Answer

Botox has not been identified as a possible cause of Bells Palsy, and shouldn’t re-trigger your initial symptoms. Botox is commonly utilized to treat asymmetry following Bells Palsy. Botox use at this stage should be considered safe. Thank you for your question.

Juan Carlos Fuentes, MD · Answer

You need to tell your injector about your medical history and that you had Bell's palsy, so the injector is aware of asymmetries, which side is weak, and in particular treating the forehead wrinkles, it is important not to make the frontalis muscle too weak or getting close to the orbital rim, it can give you a brow ptosis and have eyelid ptosis. Botox will not re-trigger Bell's palsy.

Benjamin Barankin, MD, FRCPC · Answer

I have treated a number of people with Botox who had Bell's Palsy to make the face more symmetric, and I would not be particularly concerned in Botox re-triggering Bell's Palsy since the drug is now over 20 years on the market, with millions of uses, and no such reported side effect. ~ Dr. Benjamin Barankin, Toronto Dermatology Centre.

Steven Hacker, MD · Answer

There should be no relationship between Botox injection and Bells Palsy though we are hesitant to treat patients with Botox with underlying neurologic conditions unless properly screened and advised.

	I would recommend injection only by a properly licensed board certified dermatologist or plastic surgeon.

Grant Stevens, MD · Answer

Botox will not re-trigger Bells Palsy.  Drooping of an eyelid post Botox injection is due to poor placement.

Will Botox Re-trigger Bell's Palsy?

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