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

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.

Doctor Answers 3

Crooked Smile 8 Days after Juvederm in Nasolabial Grooves

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.

Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 39 reviews

Crooked smile after Juvederm.

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. 

Ted Brezel, MD
Long Island Dermatologic Surgeon
5.0 out of 5 stars 4 reviews

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

 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.

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.6 out of 5 stars 25 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.