What are the chances that the smile stays the same after Botox in the chin?

Question

is it possible to maintain control of your lower lip when you smile after botox in chin? Or does it always result in a smile covering your bottom teeth? I need percentages please.

Nelson Castillo, MD · Answer

Thank you for sharing your question.  For most patients receiving botox into the chin Mentalis muscle it should not impact your smile.  Hope this helps.

Selena Lantry, MD · Answer

There is always a chance that your smile could be altered slightly by Botox in the chin.  However, if you discuss this concern with your provider beforehand they can use a less aggressive approach to maintain your natural smile.  You can always add more Botox, but once injected it cannot be removed or its effects undone, so I always recommend starting slow before you know how your body responds.

Carmen A. Traywick, MD, FAAD · Answer

Botox locks the release of a chemical called acetylcholine, which triggers the muscle contractions that create wrinkles.  Botox essentially paralyze the muscles and stops them from contracting.  Results from these treatments are visible within 3-7 days  with results that can last anywhere from 3-4 months. Ideally, Botox should not affect your smile and only affect chin dimpling or chin.

Anup Dhir, MD · Answer

Thank you for your question. Botox treatment in the skin should relax the muscles in the area and smoothen out the skin. It would not normally affect your smile.All the best with your treatment.

Alex Eshaghian, MD, PhD · Answer

Thank you for your question Bkbaby. I understand your concern. Botox is a purified protein used to address wrinkles associated with facial expression. When injected into the skin Botox will relax the muscles and smoothen out the overlying wrinkles. The most common areas of treatment are in the upper face. These include the horizontal lines seen on the upper forehead when one raises the brows, the vertical lines seen between the brows when one frowns (frown lines), and the crow's feet seen around the eyes when one smiles.
It is difficult to make an assessment without a formal exam in the office where I can view the skin in multiple angles and observe wrinkles formed with facial expression. However, I hope the information provided here is useful.Although Botox is most commonly used in the upper face, it can also be used in various areas in the lower face. Botox can be placed in the mentalis muscle on the chin to address a cobblestone appearance or dimpling on the chin. In this area 2-8 units of Botox are used.When Botox is used appropriately in this area, there should not be a change in the appearance of the smile. However, there may be side effects which area very rare as described below.In the lower face, the depressor labii inferioris (DLI) muscle sits between the mentalis and the depressor anguli oris (DAO) muscles. The DLI muscle is responsible for pulling down the lower lip and it is used when one smiles. If Botox spreads from either the DAO or mentalis to the DLI and relaxes the DLI it can lead to the appearance of an asymmetric smile. Some physicians try to correct it by placing Botox into the contralateral DLI muscle (on the other side). However, I recommend that my patients just wait as the effects go away on their own. This side effect resolves on its own in 2 weeks to 4 months, depending on the severity.
With any injection, there are risks such as pain, bleeding, bruising, redness, swelling, tenderness, and infection. We take special precautions to minimize these risks such as using a painless technique. We also treat bruises with a laser as early as the next day. Bruises usually resolve within two weeks if untreated. After a laser treatment bruises usually resolve in 1-3 days, but may still take two weeks for full resolution. In addition to these risks, with Botox there is also a risk that the product spreads or diffuses to nearby structures. Spread to nearby muscles can lead to side effects such as the temporary appearance of droopy eyelids or a temporary asymmetric smile.
  
After a Botox treatment, I recommend that my patients avoid heat exposure, alcohol consumption, and strenuous exercise for 24 hours and not lie down flat for four hours. This is because all of these activities may possibly lead to the movement of the product and consequent side effects such as droopy eyelids. Although there have been no definitive studies shown that these actually occur and some physicians do not provide such aftercare instructions, in the absence of data I err on the side of caution and recommend that my patients avoid such activities.
  
Please consult with a doctor for specific recommendations. Good luck!

Shelin Tkatch, MD, FRCSC · Answer

Botox to smooth the appearance of the chin area is applied to the central mentalis muscle. There are other nearby muscles that allow control of the lower lip when you smile. If these other muscles take up the Botox you can end up with a crooked smile, or even more rarely, a smile covering your bottom teeth if both sides are affected. You ask for a percentage, in my opinion this happens in far less than 1% of treatments with an experienced injector and more commonly with inexperienced injectors. It is more likely to occur if you also treat the "DAO" muscles at the same time as the mentalis muscle. These muscle pull down the corner of the mouth and relaxing them with Botox allows the mouth to have a slight upturn at rest, which is aesthetically pleasing. I prefer not to treat my patients in both areas at the same visit, so if they like to have both areas treated we separate the treatments by 2 weeks. Hope this helps. Best, Dr. Tkatch

Anita Saluja, MD · Answer

Ideally, Botox should not affect your smile and only affect chin dimpling or chin puckering when it is injected to reduce action of the mentalis muscle (chin).

Douglas Taranow, DO, FACOS · Answer

Dear DKBaby,Botox can relax the chin muscles smoothing out the skin.  There is always the chance that it may affect your smile, but it is a very rare occurrence.Dr T

Onir Spiegel, DDS, PhD · Answer

Injections of Botox or any other botulinum to the chin are often performed to relax the three muscle and undo what we'r call the orange peel effect.  In general, those infejections result in a smoother more gentle chin and easier movement in the area. There is a chance that it will affect your smile, but that should be very minimal. Holid that helps with your decision. Best from Boston, Dr. Onir

What are the chances that the smile stays the same after Botox in the chin?

Answers (9)

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