I Have Bell Palsy and Can't Use Botox, What Options Do I Have for Wrinkles?

its around one months that a frown lines appears in my face , and i want to remove it. i have a bell palsy history and I can not use Botox. So please guide me how I can remove them with out botox injection during one months because my wedding is in 5th November.

Doctor Answers 4

Anti-Aging with Facial Paralysis

In your case, I would recommend scheduling an appointment with a facial plastic surgeon to discuss your options. It’s possible that you could be a good candidate for laser treatments or Ulthera. Lasers can help eliminate wrinkles and resurface the skin. Ulthera helps to boost collagen growth at a very deep level under the skin using ultrasound. Seeing as that you have a history of Bell’s Palsy it would be beneficial to see a plastic surgeon who also has experience treating facial nerve damage, so that they can educate you completely on the options that they think will be best. Based on what you've described, it's possible that you could be a good candidate for a procedure called Selective Neurolysis which I specialize in.  I treat Bell’s Palsy patients on a regular basis and would be happy to speak with you about your concerns in more detail if you’re interested. 

Beverly Hills Facial Plastic Surgeon
4.3 out of 5 stars 9 reviews

Frown line options

Thank you for your question. The frown lines between the brows can be address two different ways:
1) Botox or Dysport can be used to soften the deepening of the frown lines when making a frown expression. The treatment may even soften the lines that are present at rest. The effects typically last 3-4 months depending on the dose. I generally use between 15-40 units of Botox (30-120 units of Dysport) in the frown area depending on the strength of the muscle and the degree of frown reduction we are trying to achieve.
2) Restylane or Juvederm can be used to soften the frown lines that are present even when you don't make an expression. This can last for a year or more when used in conjuction with Botox.
For someone who has concerns with both the static lines (without expression) and the dynamic lines (with expression), then using both products would work well together.
I often find that patients who return after a Botox or Dysport treatment in the frown areas complaining it didn't work, is due to the confusion between the static and dynamic frown lines. They continue to see the static lines even though the dynamic lines have softened considerably.

I have used Botox in patients with Bell's Palsy without inducing or making it worse.  In addition, I have used it to help create more symmetry between the two sides if you still have some residual effects.  If you want to avoid Botox for the frown lines, then you can consider using Restylane/Juvederm to address your concern.  Just realize you will still be able to frown.

Young R. Cho, MD, PhD
Houston Plastic Surgeon
4.8 out of 5 stars 37 reviews

Wrinkle therapy

Hello. Without seeing a picture of where the wrinkles are and/or examining you, it's hard to say for certain what your options are. However, laser resurfacing procedures can often be done to improve the appearance of lines on the face even in patients who are not candidates for neurotoxin (e.g., Botox) therapy.  Chemical peels may also be effective, and fillers may help certain creases look less deep. None of these non-neurotoxin techniques should be contraindicated in a patient with Bell's palsy, to my knowledge. A consultation with a local board-certified plastic surgeon will help you know whether you are a candidate for laser treatment, fillers, or peels.
Good luck!


Tim Sayed, MD, MBA, FACS
Newport Beach Plastic Surgeon
4.9 out of 5 stars 17 reviews

Frown Lines treatment ,Bell's palsy, Botox

Thank you for your question.

  • Frown lines caused by action of the frown muscles and deteriorating elasticity of skin. Botulinum toxin injections can weaken action of the culprit muscles and smooth out wrinkles.
  • Bell's palsy affecting facial nerve on one side of the face normally causes temporary paralysis of the muscles supplied by that nerve. Botulinum toxin sometimes used on the opposite side to achieve visible symmetricityin such patients.
  • If your doctor told you that Botox is not a good idea in your case, you can use dermal fillers to smooth out the frown lines. Less viscous dermal filler is advisable for this purpose. You also can combine a chemical peel or Laser treatment with a Dermal filler in order to get overall improvement of skin quality before your big day.

Alexandra Chambers, MD, PhD
London Dermatologist
4.7 out of 5 stars 29 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.