Nerve damage due to Botox?? (photos)
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Doctor Answers 7
Weak / Asymmetric Smile After Botox Injection
Botox does not affect sensory nerves. The infraorbital nerve is a sensory nerve, and is not affected by Botox. The infraorbital nerve supplies sensation to the medial portion of the cheek, the upper lip, the side of the nose, and the lower eyelid.
Zygomaticus major and zygomaticus minor muscles are responsible for elevating the corner of the mouth / lip when you smile. The weakness in your smile is related to Botox affecting the motor nerve function to the zygomaticus major and minor muscles. Experienced Botox injectors know to avoid this area, for the reasons you have experienced.
I am confused why your doctor chose to inject a local anesthetic into this area as well. Most local anesthetics last only a few hours, so I would suspect that your numbness has subsided. If your numbness has not subsided, then further evaluation is warranted.
The effects of Botox are not permanent. The muscle weakness/ relaxation caused by Botox typically ranges from 3 to 6 months, with the average relaxation being about 4 months duration. How long your weakness will last depends upon how much Botox was injected into this area, and how much of the muscle was affected. It is possible that after about a month you may start to see some gradual improvements on a week to week basis. I suspect that by about four months or so you should see relatively reasonable return of muscle function.
My advice moving forward would be to find an experienced Botox injector for your next treatment. Best wishes.
Asymmetric smile after Botox is related to the zygomaticus muscle being affected
Never Damage Due To Botox -- This Wont Last!
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Based on your photo, your Botox treatment weakened your left zygomaticus major muscle.
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- the infraorbital nerve is a sensory nerve, providing sensation to the lower eyelid, the side of the nose, the cheek and upper lip. It doesn't move any muscles. If the numbness has worn off, then you don't have any damage to the infraorbital nerve. If numbness is still present then further investigation is warranted.
- the asymmetry with your smile is due to injection of Botox into the muscles involved in smile -- zygomaticus major & minor. Botox works where the nerve meets the muscle, so the nerves that move these muscles are also okay, it's just that their muscles have been Botox'ed. Why Botox was injected around those muscles, and why your surgeon followed up with a numbing agent, is a mystery to me.
Harry V. Wright MD
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.