I had bad Dysport that apparently migrated to the lower lip. Please help? (Photo)

Question

I had bad Dysport that apparently migrated to the lower lip depressor muscle on one side. I have no idea how this happened. It looks awful. I know I have to wait it out but I am considering getting a small dose of botox or dysport in the non paralyzed side depressors to even it out. Please help? Would this make it more symmetric while waiting this out.

Brent Moelleken, MD · Answer

Dysport tends to spread more than Botox.  That being said, let your doctor know of the problem and assess your situation.  You wouldn't want to relax the good side, then the 'bad' side recovers!If you have lost confidence or the injection was done by an unqualified practitioner, definitely seek advice from a doctor who performed these injections routinely.

Martin Jugenburg, MD · Answer

This is an injector issue not a Dysport issue.  Do not try and correct it by treating the unaffected side.  It is best to let it wear off.

Scott C. Sattler, MD, FACS · Answer

Botox can be used to treat the mentalis muscle - this often produces a smoother appearing chin. Incorrect injection technique can partially weaken the DAO muscle and produce an uneven smile.

Michael A. Zadeh, MD, FACS · Answer

Sorry to hear this happened to you. Things will go back to normal once the Dysport starts to wear off in 2-4 months. You can try adding some to the other side to make it a little more tolerable, but honestly, trying to fix this may cause more problems. I would recommend just waiting it out and letting it wear off. Please find an experienced injector next time. Best wishes.

Jason Emer, MD · Answer

This will typically resolve in a short amount of time (2-4 months). You can try to even it out by injecting the other side, but my advice is to wait a few weeks. It will start to dissolve. Best, Dr. Emer

Hardik Soni, MD · Answer

This will wear off in 3-4 months. You can even it out by injecting the other DAO muscle, but it is best to wait. Remember to always see an expert injector.

Corey Frucht, MD, PhD · Answer

Hello, and thanks for your question and photo. Sorry to hear you've had trouble. I do not recommend trying to fix this with more Dysport -- I'd wait it out for ~3 months. Try switching to a different dermatologist. Best of luck, Dr. Frucht.

Firas Al-Niaimi, MD, MRCP, EBDV · Answer

I am sorry to see this has happened to you. Dysport tends to spread a bit more and this is also related to the injector. In the future I suggest using a different brand with a lower constitution (example 1 ml instead of 2.5ml) to avoid any physical spread of the toxin. I do not recommend paralyzing the other area as it will affect you eating. The best action is to do nothing but to wait until it wears off.

Occasionally physiotherapy (yes you can see a physiotherapist) can help by trying to strengthen the weakened muscle.

Occasionally physiotherapy (yes you can see a physiotherapist) can help by trying to strengthen the weakened muscle.

Julio Clavijo-Alvarez, MD, MPH, FACS · Answer

I am sorry that you are having issues about your procedure and thanks for sharing your question. I can appreciate your concern.

Use of Botox to the other side might help with symmetry. however, you are risking to have the same effects on the other side. Make sure that your injector is experienced.Finally, make sure that you have a consultation with a board certified plastic surgeon.

Wishing you the best in your journey

Shaun Patel, MD · Answer

I would suggest just waiting the 6-8 weeks for the Botox to wear off rather than then getting the contralateral DLI muscle injected. The mentalis and DAO muscles are commonly injected with Botox to treat a cobblestone appearance of the chin and downturned corners of the mouth, respectively. In both cases, the injector must be careful to avoid the DLI muscle. In your case, unfortunately, the Dysport spread to the DLI muscle.

I had bad Dysport that apparently migrated to the lower lip. Please help? (Photo)

Answers (18)

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