Uneven facial muscles after Botox (Photo)

Question

I have been injected with 2 units of Botox on my chin It resulted in a crooked mouth when I talk or smile I went back after 2 weeks he injected me with1 unit it made it worse,then he gave me mistonin to help fade away the Botox, toady after a month and a half I visited a neurologist he says I have an overactive muscle, he gave me muscle relaxers, my qoueation is what went wrong and could this be permanent ? I really don't want to inject more Botox , is there anything else I can do

Nelson Castillo, MD · Answer

Thank you for sharing your question and photograph.  Inadvertently one of the muscles responsible for lowering your lower lip on your right side was paralyzed leading to your smile asymmetry.  Unfortunately there is no antidote to Botox you will need to simply allow it to wear off on its own.  Luckily you had very little injected so it should not take 3-4 months.  One other option is to use Botox to paralyze the other side of your smile to even out your lower lip.  Hope this helps.

Faraz Valaie, MD · Answer

Hi,
I am so sorry to hear about this...
My guess is that Botox is in the wrong muscle (either it has moved to the wrong muscle or has been injected in the wrong muscle)
I would give it couple of months and this should be back it normal
If there is any other muscle involved, then I would worry... if not please wait :)

Sheryl D. Clark, MD, FAAD · Answer

Dear LNF81:Your uneven smile is due to some migration of the Botox that was injected in your  depressor anguli oris muscles (DAOs) to the depressor labii inferioris (DLI). This happened on your right side only. The depressor anguli oris is responsible for pulling down the lower lip when you smile, and it lies behind and medial to the DAO. Since this muscle is relaxed on the right side, when you smile the lower lip is pulling downward on the left side only.Fortunately, this will wear off in time. In the meantime, if you want to have a more symmetric smile, your physician can inject a very small amount of Botox directly into the DLI on the left side. All the best, Dr. Clark

Faiyaaz Kalimullah, MD, FAAD · Answer

Thank you for your question and for sharing your photo.  I'm very sorry to hear that you are experiencing complications from your Botox treatment.  It's impossible to make exact recommendations without assessing you in-person, but based on your photos it appears that the Botox injected in your chin area has drifted and affected the muscles that control your lower lips.  The effects of Botox typically last 3-4 months, and I would anticipate that your facial muscle movement should start to improve in the next several weeks.  Best of luck!

Alex Eshaghian, MD, PhD · Answer

Thank you for
your question LNF1. I am sorry to hear about your situation. Botox is a
purified protein used to address wrinkles associated with facial expression. In the lower face Botox can be placed in the chin to address dimpling there. Any time Botox is injected it is possible to spread to nearby muscles and relax them. In this area it can spread to the adjacent DLI muscle and lead to a temporary asymmetric smile. Most people enjoy their results for 3-4 months and such side effects should not last longer than this. With low doses (2-4 units) side effects usually resolve more quickly. Please consult
with a doctor for specific recommendations. Good luck!

Uneven facial muscles after Botox (Photo)

Answers (7)

Answer: Uneven facial muscles after Botox

Answer: Uneven facial muscles after Botox

Answer: Asymmetric smile after Botox

Answer: Asymmetric smile after Botox

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Uneven facial muscles after Botox (Photo)

Answers (7)

Answer: Uneven facial muscles after Botox

Answer: Uneven facial muscles after Botox

Answer: Asymmetric smile after Botox

Answer: Asymmetric smile after Botox

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Everything you need to know about Botox

Our mission is to create a world where every investment in modern beauty is Worth It.