Botox to chin causing weird changes in mouth movement & lip shape - 5 units in the bottom left & right edges of chin (10 total).

Approx 2 weeks ago, DBCPS said injecting in this area would help alleviate my tendency to unwittingly make this odd sort of "frownie face" I catch myself making when I's reading. Since, my speech is slightly slurred, & when I speak, my mouth moves in an entirely different way than before & people are asking me what's wrong. I'm actually frowning MORE just from saying certain words. It is also difficult to smile. The point was to achieve the opposite, based on his recommendation. What's the problem?

Doctor Answers 7

Botox to chin causing weird changes in mouth movement & lip shape - 5 units in the bottom left & right edges of chin

Thank you for your question.  Without a photograph to see what is taking place, it is difficult to make recommendations as to which muscle in the chin area was affected causing some lip and smile asymmetry.  If placed below your lips near the center of your jaw, attempts at paralysis of the mentalis muscle can cause some odd puckering of the skin, while if the injections were placed closer to the corners of the mouth, attempts at paralysis of the depressor anguli iris muscle may have been unsuccessful, or paralyzed another muscle to create an imbalance.  Voice your concerns with your injector to avoid this in the future, but unfortunately only time will help correct this.  

Atlanta Plastic Surgeon
4.9 out of 5 stars 65 reviews

Botox to chin causing weird changes in mouth movement & lip shape - 5 units in the bottom left & right edges of chin

Over dosed amounts. But best news this does wear off in a few months!>>>>>>>>>>>>>>>>>>>>

Darryl J. Blinski, MD
Miami Plastic Surgeon
4.6 out of 5 stars 173 reviews


Petunia83, I think you will have to wait for the Botox to wear off and then you may want to see a different provider. Good luck!

M. Sean Freeman, MD
Charlotte Facial Plastic Surgeon
4.7 out of 5 stars 48 reviews

Botox for the chin

Thank you for your question Shortcake83. 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 a small amount of Botox can be placed in the mentalis muscle on the chin to address dimpling there on in the DAO muscle to address a downturned appearance of the corners of the mouth. Care must be taken to use a low dose and to place the Botox correctly. If Botox spreads to the neighboring DLI muscle (located between the mentalis and DAO) a possible side effect could be an asymmetric smile and difficulty moving the mouth. Please consult with a doctor for specific recommendations. Good luck!

Alex Eshaghian, MD, PhD
Encino Physician
5.0 out of 5 stars 3 reviews

Botox to chin causing weird changes in mouth movement & lip shape - 5 units in the bottom left & right edges of chin (10 total).

Hello Petunia83,

Injecting the depressor anguli oris (DAO) can help to turn the corners of the mouth up by weakening this muscle that is pulling the corners down.  Because it is affecting a muscle that moves the mouth, it can give patients a strange feeling around the mouth.  Patients tend to either love it or hate it.  I personally start at a lower dose than you had in that area, but each injector has a preference.  Since you are not liking your result, in the future consider a lower dose.  Based on your original description it seems like that may have worked for you. 

I would recommend you follow up with your injector to discuss your concerns.  The good thing is that the result is only temporary.  If you continue to not like it, the effects will go away and the area will look better.

I hope this helps and good luck. 

William Marshall Guy, MD
The Woodlands Facial Plastic Surgeon
5.0 out of 5 stars 28 reviews

Botox can affect smile

Botox can be highly successful when placed into the DAO (depressor anguli oris) muscle.  An active DAO will cause a downward frowning mouth.  Small amounts of Botox will turn the mouth upward in many cases.  Some patients do not like the altered feel of the mouth. 
Without careful placement or with higher doses, it can alter your smile or speech with movement
DAO Botox can be a win, but not all patients like it.  If it migrates into your other lip muscles and causes visible changes in your look you will not like it.  Small doses of further Botox can help with asymmetry.
Good luck and check back with your plastic surgeon.

Keith Denkler, MD
Marin Plastic Surgeon
5.0 out of 5 stars 18 reviews

Botox to Chin Side Effect

Hello, Botox injected into your mentalis muscle (chin) helps it dimple less and injected into your DAO muscles (for corners of mouth) helps the corners of mouth slightly lift from a downward turn.  These are off-label uses for Botox, but are commonly done for anti-aging in the peri-oral area. Botox may migrate to other unintended muscles, causing side effects like you describe, and this appears to be what has happened. I suggest calling your injecting doctor for re-evaluation. 

Anita Saluja, MD
Melbourne Dermatologist
5.0 out of 5 stars 18 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.