Ocular/oral synkinesis: Botox injections to eye or around mouth?

Question

I have had long standing synkinesis. The most troubling is that when I blink, my DAO, DLI, Mentalis and zygomatic major twitch. It is pretty strong mass movement. I have been doing Botox for years and the results are mediocre as it affects my smile and regular mouth movements. I have seen experts. But I am wondering if I should be trying botox around my eyes instead? Perhaps stopping the constant blinking? It does seem as if I also have excessive blinking. What doctor would I see?

Daniel Barrett, MD · Answer

Dear Abbylucy123,it is hard to tell without an examination. I would suggest you to consult a board-certified plastic surgeon. Only after a thorough examination you will get more information and recommendations.Daniel Barrett, MD, MHA, MS 
Certified, American Board of Plastic Surgery  
Member, Am. Society of Plastic Surgery

Jason Emer, MD · Answer

This is difficult to answer without pictures and needs an in-person evaluation. Botox may be able to give improvement. Botox results last 3-4 months in new areas of treatment. I recommend getting a formal evaluation with an expert. Best, Dr. Emer

Mitesh Kapadia, MD, PhD · Answer

Its hard to tell whats going on without examining you in person. If you feel you need Botox around your eyes, see an oculoplastic surgeon who should be able to help.

Daniel Lensink, MD · Answer

Botox only stops muscles from reacting to a nerve impulse. Stopping the muscles around your eye from contracting with a nerve impulse by injecting botox around the eye will do nothing to affect abnormal nerve impulses being sent to your mouth muscles. Your best bet is to continue working with your doctor to continuously modify your treatments to optimize your result. Unfortunately you will never be able to completely stop the abnormal impulses without having an effect on the muscles when you want them to contract. But patience and a doctor who will take the time to work with you is the best solution.

Ocular/oral synkinesis: Botox injections to eye or around mouth?

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