Crooked Smile 8 Days After Juvederm in Nasolabial Folds, Why Would this Happen?

Question

I had Juvederm in my nasolabial folds, and it looked great - hardly any swelling, no bruising, very natural look. I have a picture taken exactly 48 hours later (with a big smile) that confirms this. 8 days later, I woke with an asymmetrical smile. My left side is normal, but I am only able to half-smile on the right, and my cheek is dropping. I started a steroid taper yesterday in case it's a nerve, but I have no pain. I also thought Juvederm didn't migrate after 1-2 days. I look a bit odd.

Ted Brezel, MD · Answer

This does not sound like an issue with Juvederm but I would be concerned that you have developed Bell's Palsy. I would get over to a neurologist for further evaluation.

Richard W. Fleming, MD (retired) · Answer

It is extremely unlikely that your asymmetrical smile and drooping cheek are secondary to the Juvederm injections. I suggest you talk to you physician and consider a consultation with an ENT specialist to rule out the possibility of a Bell's Palsy, which is a temporary weakness of the facial nerve. If this diagnosis is made, early treatment may accelerate recovery.

Francis R. Palmer, III, MD (retired) · Answer

This is a bit odd. There is a local anesthetic in the Juvederm that could affect the infra-orbital nerve however, this is a sensory nerve and not a motor nerve. Affecting this nerve would create numbness not muscle weakness and a droopy upper lip. If this muscle weakness does not improve in a day or so, yopu may ask the MD that did the Juvederm injections for a referral to a neurologist to rule out a Bells Palsy. The upper lip has multiple small nerve branches, of the facial nerve, that should not be affted by injections in the nasolabial folds.

Crooked Smile 8 Days After Juvederm in Nasolabial Folds, Why Would this Happen?

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