How long until 10 units of Botox wears off? Is there any correctional action that can be done? (Photo)

Question

Hello, I got Botox for bells palsy synkenisis two weeks ago and can no longer lift the affected corner of my mouth to smile. I'm crushed. He put 10 units somewhere in my cheek for tightness and I'm guessing that's the culprit. How long until 10 units wears off on this area? Is there any correctional action that can be done?

Anna Chacon, MD, FAAD · Answer

I'm sorry you're going through this. After working so hard to regain facial movement, it can be very discouraging to feel like your smile has taken a step backward.

The good news is that Botox does not permanently weaken the muscle. When Botox is injected into the cheek to reduce synkinesis or muscle tightness, it can sometimes spread to nearby muscles that help elevate the corner of the mouth. If that happened, it could explain why you're having difficulty smiling.

At two weeks, the Botox is typically at or near its maximum effect. In most people:

Improvement begins around 6–8 weeks as the medication starts to wear off.
Most of the effect is gone by 3–4 months, although the exact timing varies from person to person.

Unfortunately, there isn't a medication that can immediately reverse Botox once it has taken effect. However, there are a few things that may help while you're waiting:

Facial neuromuscular retraining or physical therapy with a therapist experienced in Bell's palsy can help you maximize your facial function and minimize compensatory movements.
Gentle facial exercises may be recommended by your therapist, but I would avoid vigorous or unsupervised exercises, as they can sometimes worsen synkinesis.
For future treatments, your injector can often adjust the dose or injection location based on this experience. Even small changes can make a significant difference in balancing muscle relaxation while preserving your smile.

The fact that this occurred after treatment doesn't necessarily mean Botox isn't right for you it may simply mean that your treatment plan needs to be fine-tuned. Managing synkinesis is often a process of gradual adjustments to find the right balance between reducing unwanted tightness and maintaining natural facial movement.

Although I know it feels overwhelming right now, this effect is temporary, and your ability to lift the corner of your mouth should gradually return as the Botox wears off.

Camille Cash, MD · Answer

I'm sorry to hear of the issues you are having from your Botox treatment.  Botox results are temporary and will gradually fade over three to four months.  There is no reversal agent for Botox.

Anna Avaliani, MD · Answer

You have rather unfortunate side effect and I completely feel for you. Your doctor should know how to treat this. There is medication you can take to make it wear off faster. This medication is used to treat Botulism and Myasthenia gravis. It is of course off label , so there are risks that need to be discussed . There is hope. Good luck.

How long until 10 units of Botox wears off? Is there any correctional action that can be done? (Photo)

Answers (3)

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