Botox caused a horrible crease above lip. I had 4 units above upper lip for vertical lines. Can this be fixed? (photos)

Question

My side effects are are that I can’t enunciate (real effort to talk), my jaw hurts (from overcompensating?), and a new horrible crease above lip/under nose when I smile. It’s very unattractive and looks like a second smile. Is there anything I can do to fix it? 2 of the photos below are before - and 2 are after photos

David Yew, MD · Answer

Botox in the upper lip is not for everyone.   I always warn patients that some will experience what you are feeling.  The upper lip lines are a result of puckering (some people erroneously call them "smokers" lines)   Any movement that causes puckering will be affected.   This can present with difficulty enunciating hard syllables, sipping through a straw or whistling.   It's temporary and will go away in 2-3 months.   (Sooner than wrinkles in other areas of the face)   In our practice - I give this injection free for patients that want to try for the first time.  If they can tolerate it - then I charge them the next time.   The crease under the nose is a result of the muscles underneath being relaxed.   That too will go away.
Go back to your provider and let them know your experience.   If they have integrity and did not warn you about this during the initial consult - they should refund or credit that amount.   That's what we would do.

Nicholas Gentry, MD · Answer

I have injected botox in this area many times. The trouble you are having with enunciation/straw use is a very common side effect. I ALWAYS warn my patients that this is an issue but it is usually very mild. The horizontal line is definitely unusual. It should not be permanent. If you decide to repeat botox in this area, I would recommend .5 units in 4 areas and wait 10-12 days for a repeat dose if needed.

Spa 35 - Boise · Answer

Was this your first time injecting above the upper lip? I usually have my clients start at 2 units there, and then they can increase if they don't see any results. It is normal to feel a little funny in that area (we use those muscles ALL the time for eating, talking, etc) when you first get botox there. It appears that other muscles are now pulling around your mouth and creating the horizontal line that you don't like (I promise you - you notice it more than others. Some people have that horizontal line naturally. And the best news is that it should go away as the botox fades). Unfortunately there is nothing you can do to speed botox's wearing off. BUT, you are lucky in that around the mouth is the area where botox usually wears off the quickest (also because we are always talking, eating, etc). I'm sorry this happened to you. Some people love botox in that area, and some people hate it (some for the same reason as you). Give it approx 4 weeks and it will likely start to wear off.

Botox caused a horrible crease above lip. I had 4 units above upper lip for vertical lines. Can this be fixed? (photos)

Answers (3)

Recommended reading

Everything you need to know about Botox

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

Botox caused a horrible crease above lip. I had 4 units above upper lip for vertical lines. Can this be fixed? (photos)

Answers (3)

Browse related questions

Recommended reading

Everything you need to know about Botox

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