Does Botox increase the chance of Bell's Palsy reoccurring? (photos)

Question

I had Bell's palsy in Oct 2023, and I promptly received treatment w/ steroids, which resulted in a great recovery. However, there are some minor facial issues that I would like to address such as masseter muscle, undereye wrinkles, lift my eyebrows, and balance my face. I consulted a dr in Tijuana who expressed concerns that any application of Botox may trigger a new episode of Bell's palsy. Could you clarify whether receiving Botox poses a risk of causing Bell's palsy to recur?

Jose Telich, MD · Answer

Dear Allegra_00, thank you for your thoughtful and important question.
Botox (botulinum toxin) does not increase the risk of Bell's palsy recurring. Bell’s palsy is a sudden, usually temporary paralysis of the facial nerve, often related to viral inflammation, whereas Botox works at the neuromuscular junction to temporarily weaken targeted muscles—it does not affect the nerve itself.
There is no robust scientific evidence linking Botox injections with the recurrence of Bell’s palsy. In fact, Botox is often used as a treatment for certain forms of facial asymmetry or unwanted movement that can follow facial nerve palsy—especially in cases of synkinesis or muscle tightness.
That said, it’s important that your injector is experienced, doses are conservative, and a thorough evaluation is performed before injections. 
You might consider seeking care from a plastic surgeon or neurologist with experience in facial nerve disorders.

Randal Haworth, MD, FACS · Answer

The association between Botox injections and the recurrence of Bell's palsy is not well-established. Botox works by temporarily relaxing muscles, and its use for cosmetic purposes is generally considered safe.

While the risk is generally low, your doctor's concerns may be rooted in caution. It's advisable to seek a second opinion from a neurologist or another healthcare professional who specializes in facial nerve disorders to get a more comprehensive understanding of your specific situation and potential risks.

Best of luck !

Does Botox increase the chance of Bell's Palsy reoccurring? (photos)

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