Botox is spreading to my lower face. Is this common?

I have been afraid and freaking out. I had botox injected to forehead and glabellar area on Tuesday and it has spread to my lower face and I have even felt a lot of other muscles "turning off" in the rest of my body. The first time I had it everything went fine. Went back again,same doctor (very famous and world renown plastic surgeon) and now my whole lower face is frozen as well and I'm only on day 4. I can hardly smile,talk and I am afraid. Is this common?

Doctor Answers 11

#Botox does not migrate to the lower face from the upper face

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I am concerned about your symptoms but they are not due to #Botox. I suggest you consult your primary care doctor.

New York Dermatologist
4.7 out of 5 stars 10 reviews

Migrating botox

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It would be very unlikely that your symptoms are caused by your botox treatment.   I would suggest that you visit your doctor immediately for a complete examination.  

Martin Jugenburg, MD
Toronto Plastic Surgeon
4.9 out of 5 stars 518 reviews

Atypical reaction to Botox

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Hi.  Sorry to hear about your trouble.  The symptoms you are describing are unusual.

You should return promptly to your injecting physician for a complete neurological evaluation.  An online forum like this is not likely to provide the specialized advice you need.

All the best,

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Botox migrating to the lower face

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Thank you for your question. It is very uncommon to experience symptoms like these after Botox, see your provider so they can asses you in person. Botox is a localized injection and unless injected in an excessively large quantity has not been associated with problems like these leading me to believe you are experiencing symptoms related to something else.

Best Wishes,
Pablo Prichard

Pablo Prichard, MD
Phoenix Plastic Surgeon
4.9 out of 5 stars 42 reviews

Very unusual but not impossible...

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very rarely people can have unusual, unexplained reactions to botox...overwhelmingly these complaints have nothing to do with the botox...sometimes stress, Bell's palsy or other reactions...but there have been some extremely unusual reactions...especially with large doses...after review, the FDA required adding a special notice to the package's a copy taken directly from it...(obviously you should return to your doctor to discuss the matter)

BOTOX® may cause serious side effects that can be life threatening. Call your doctor or get medical help right away if you have any of these problems any time (hours to weeks) after injection of BOTOX®:

  • Problems swallowing, speaking, or breathing, due to weakening of associated muscles, can be severe and result in loss of life. You are at the highest risk if these problems are pre-existing before injection. Swallowing problems may last for several months
  • Spread of toxin effects. The effect of botulinum toxin may affect areas away from the injection site and cause serious symptoms including: loss of strength and all-over muscle weakness, double vision, blurred vision and drooping eyelids, hoarseness or change or loss of voice (dysphonia), trouble saying words clearly (dysarthria), loss of bladder control, trouble breathing, trouble swallowing. If this happens, do not drive a car, operate machinery, or do other dangerous activities

Ken Landow, MD
Las Vegas Dermatologist

Botox migrating from upper face to lower face

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Botox cannot migrate from the upper face to the lower face. It is a localized injection into muscle which cannot travel down the face. Like all other doctors on here, I recommend you see your injector and/or primary care physician. Some of what you are describing sound like you might be getting a case of Bell's Palsy, which is unrelated to the Botox, but coincidence that it's occurring right after. The descriptions you are stating sound somewhat similar to this and that's why I recommend you been seen as soon as possible for an in-person evaluation.

"This answer has been solicited without seeing this patient and cannot be held as true medical advice, but only opinion. Seek in-person treatment with a trained medical professional for appropriate care."

Botox does not migrate

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These are extremely unusual symptoms you are describing. Botox is not known to migrate to other parts of the face, much less the body. I suggest returning to your plastic surgeon to be examined as soon as possible.

Arnold Almonte, DO
Roseville Plastic Surgeon
4.9 out of 5 stars 35 reviews

Botox not spreading

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You report that Botox was injected into your forehead and glabella and now your lower face and a lot of other muscles are "turning off". My humble opinion is that something else, unrelated to Botox injection is creating your concern and anxiety. The symptoms you are describing are not related to localized injection of 40-50 units of Botox in the upper face by a world renowned plastic surgeon, but may be suggestive of somatization disorder. I strongly recommend consulting your primary care and possibly obtaining appropriate referral to a qualified medical provider specializing in diagnosis and treatment of the disorder. Also, any suggestion that a respectable plastic surgeon would inject his or her patients with illegal or unsafe neurotoxin to save a few dollars is ludicrous and irresponsible. 

Edwin Ishoo, MD
Cambridge Facial Plastic Surgeon

Apparent Botox Spreading Effect

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It is highly unlikely that you are seeing such a "systemic effect" from the injection that your doctor provided for you. If this is the case, I am certain your doctor wants to hear from you. Call the physician who injected you. As you said, your physician is reputable, and will take good care of you. Remember, common things are common, it is extremely unlikely that your Botox injection created the findings you are seeing.
It is always best to communicate with your trating doctor.

Greg Chernoff, MD
Indianapolis Facial Plastic Surgeon
4.7 out of 5 stars 32 reviews

Spreading effect of Botox

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When injected properly and at the proper doses, Botox will not spread beyond the specific muscles injected in your face.  No other parts of your face or body should be "turning off".  I recommend you talk to your doctor immediately and get examined. 

Daniel Yamini, MD
Los Angeles Plastic Surgeon
4.8 out of 5 stars 21 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.