When a Doctor Injects Botox Around Mouth for Smokers Lines, Are They Injecting into the Lips or the Muscles Around the Mouth?

As others have noted, the neuromodulation effects occur in the muscles responsible for the unwanted lines.  Around the mouth, the relaxation can lead to weakness of contraction which will soften the harsh lines.  This may also create the inability to pucker, kiss, whistle, suck through straws, and may even affect speech and enunciation.  Some patients report enough dyskinesis (uncoordinated movement) to bite their lips inadvertently.  Your physician may be very experienced and best qualified to have you reach the right effects in this area.  Otherwise, be aware of the potential risks and wait out the complications. 

Botox, especially when combined with fillers, can achieve excellent results for lip lines.  The Botox is typically injected into the "white" lip rather than the "red" lip.  As has been pointed out, these injections can occasionally result in asymmetries in movement of the mouth, and difficulty in pursing the lips.  Your best chance of achieving an excellent result is to see someone who performs these procedures frequently, but even then occasional asymmetric movement can result.  Sometimes this can be remedied with additional injections, but unfortunately sometimes only time will improve the condition.  If you question whether your doctor has the knowledge to be successful treating you,  get a second opinion before trying to correct your current problem.

Botox is injected by many doctors into the skin above the muscle, but some inject it into the muscle. It also depends on where on the face the injection is to take place and the concern of bruising.  The exact location and number of units is more of an issue as the muscle underlying the skin insertion will ultimately be affected whether it was injected directly or affected by the proximity of the placement.

Botox is always injected into a muscle, unlike artificial fillers that are injected into soft tissue.  Botox is a neuromodulator, and its action targets muscle activity, specifically weakening target muscles to attain the desired aesthetic improvement.  Perioral rejuvenation with Botox requires a very experienced injector, and should be initially injected in small quantities to prevent complications and establish a baseline for future injections.  To treat "smoker's lines" Botox is injected into the upper lip. By relaxing the upper lip Orbicularis Oris muscle Botox reduces the appearance of "smoker's lines".  Botox can also be injected into the lower lip Depressor Anguli Oris muscle reducing the downward pull of these muscles creating a turned-up corner of the mouth.  It is possible that your injector did not satisfactorily target the appropriate muscle, and therefore you did not achieve the desired elevation to the corner of your mouth.  I suggest you follow up with the practitioner and voice your concerns..... Dr. Corrado

Botox can be very helpful for treatment of "smoker's lines" around the mouth. The main risks include asymmetry (more/ less effect on one side) and involvement of muscles that the injector did not intend to weaken. That is likely what is happening in your case as you've noticed some difficulty elevating one side of your mouth. The upside is that this effect is temporary and will wear off. I would recommend returning to your injector to mention your concerns. It is possible, in certain cases, to inject a small amount of additional Botox to provide summetry or just wait until the effect of the Botox dissipates. These injections are always performed into the muscle surrounding the mouth as opposed to the body of the lip itself.Stephen Weber MD, FACS

Botox, in small amounts, can work well to reduce “smoker’s lines” when injected appropriately around the lips. Since Botox is intended to soften the fine lines caused by muscle movement, it needs to be injected to the “white lip” and not into the actual “red lip.” Depending on the amount of Botox that was injected, the asymmetry may improve slightly over the next few weeks. I would make an appointment to see the physician and discuss your concerns. Good luck!

 

Dr.Sunder
Beverly Hills, Los Angeles

Botox, like other neuromodulators such as Dysport, is injected into hyperactive muscles that cause wrinkles including smoker's lines. It would never be directed directly into the lips as you would with fillers, for example Juvederm or Restylane. More common areas for Botox are the crow's feet and the vertical furrows between the eyebrows. Because the muscles around the mouth affect the movement of the lips, special expertise is required but it can work very well as you know.

I don't think patients get as much for their money with Botox around the mouth vs. Juvederm. I think patients who get Juvederm get a better result of lessening the lines.

While any of the neuromodulators like Botox, Dysport, PureTox and Xeomin can be used to minimize the muscles around the mouth, this is a VERY technical injection that is best done by a VERY experienced physician. I rely more on fillers like Juvederm or Restylane to soften lip lines. These prodcuts are placed both in the lips and diluted to be able to be placed into the verticle lines. Again, I recommend only seeing a physician who is expert in this procedure.

Yes tiny does of BOTOX can ease perioral lines.  However, it can also weaken the muscles that purse the lip.  Treatments may not be symmetric.  The use of fillers in the lips and periorally is a much better option.  At this point, the only option is to let the BOTOX wear off.  Please do not double down on this bad treatment by letting you "doctor" inject more BOTOX.