I got Botox injections for migraine/bruxism.Now about a week from the operation I can't smile normally, what do I do? (Photos)

I had injections in messeter muscles, neck and forehead.This was second time at neurologist. What is my future doctors?

Doctor Answers 5

Smile problems after Botox

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Hi there,


Unfortunately it appears as if the Botox inadvertently paralyzed one/some of the several muscles that control smiling. Only time will fix this problem, as Botox usually remains effective for 3-4 months. Good luck.


Plantation Plastic Surgeon
5.0 out of 5 stars 45 reviews

Botox for migraine/bruxism. Now about a week from the procedure I can't smile normally

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Thank you for sharing your question and photographs.  It appears that your injections were placed in such a position that it resulted in your lip elevating muscles being accidentally paralyzed.  Unfortunately there is no reversal outside of time, but there is no permanent or long-term damage.  Hope this helps.

Nelson Castillo, MD
Atlanta Plastic Surgeon
5.0 out of 5 stars 80 reviews

Unhappy with Botox/Xeomin/Dysport for Migraines--add venus legacy

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This may be due to Botox placement, but it can take 1-2 weeks for final results with Botox. Botox results last 3-4 months. If you're unhappy with your final results, venus legacy treatments can soften results. See an expert. Best, Dr. Emer

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.8 out of 5 stars 207 reviews

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Can't smile normally after Botox for migraine and bruxism...

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Thank you for your question and pictures. I am sorry to hear about your issue. It does appear a muscle that help with smiling has been affected. It is a rare complication when injecting at those areas. It will fully resolved in 3 to 4 months and you may see an improvement as early as 4 to 6 weeks. I recommend following up with your injector. All the best, Dr. Michon

Can't smile normally...

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Thanks for posting. The Botox has relaxed the muscle used in smiling. This may last 3 to 4 months or less if it's migration. You should see your injector and review the number of units and location injected. 

Best wishes, Dr. Aldo

Aldo Guerra, MD
Scottsdale Plastic Surgeon
4.9 out of 5 stars 215 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.