6 months post op, Botox has ruined my face! Any suggestions? (photos)

Question

I have now begun month six of this nightmare having had 15 units of botox injected into the DAO muscles ruining my smile! Will this ever return to normal. I am devastated at the destruction this has created to my smile chin and jawline. I look nothing like the person who was injectef 6 months ago and now fear this is forever me!

Sue Ellen Cox, MD · Answer

Nicolami6, I’m so sorry to hear about your negative experience. The number of units used is your treatment is much higher than what I would recommend for that muscle group. The good news is that your smile, chin and jawline will return to normal. In my 20+ years specializing in aesthetic dermatology, I have never come across a case of “permanent” Botox. Durability of results varies by patient and dose, but at six months post treatment, you will likely see the results begin to diminish shortly.

If you haven’t already, make sure to enquire about your doctor’s credentials and experience. A board-certified dermatologist or plastic surgeon who specializes in Botox use will be best positioned to address your unique anatomy and goals.

If you haven’t already, make sure to enquire about your doctor’s credentials and experience. A board-certified dermatologist or plastic surgeon who specializes in Botox use will be best positioned to address your unique anatomy and goals.

Leo Lapuerta, MD · Answer

I would still give it time. Botox should wear off over time and the time frame is different for everyone.

Andrew Campbell, MD · Answer

So sorry to hear about your problem. The good news is that a Botox injection should not be able to cause a permanent problem. Hopefully, your smile will return to normal soon. I'd discuss your concerns with your injector so they can follow you and make sure you are ultimately satisfied.Andrew Campbell, M.D.Facial Rejuvenation SpecialistQuintessa Aesthetic Centers

Jason Emer, MD · Answer

At this point, the Botox should be wearing off and will be gone soon and you'll return to normal. If you'd like to try another technique next time, in our practice we combine a small amount of Botox with other fillers "layered" on top to get the most conservative natural look. Please see a facial sculpting expert.  Best, Dr. Emer

Adam Tattelbaum, MD · Answer

Sorry to hear your concern. The botox will eventually wear off and things should return to normal. It will likely just take more time.Best wishes.

Hardik Soni, MD · Answer

Fifteen units of Botox injected into the DAO muscles are too much. Botox typically last 3-4 months. At 6 months your Botox injections should wear off soon and should have your beautiful smile back.

Alex Eshaghian, MD, PhD · Answer

Thank you for your question nicolami. I am sorry to hear about your
situation. Botox is a purified protein used to address wrinkles associated with
facial expressions. In the lower face Botox can be placed in the DAO mulsce to elevate the corners of the mouth or in the mentalis muscle to help with dimpling on the chin. If Botox spreads to the neighboring DLI muscle located between the DAO and mentalis it can result in a temporary asymmetric smile. The bottom of the photograph of the chart is cut off so it is not possible to see how much was placed in the DAO. Also 15 is written on the mentalis muscle so it is not clear if this muscle was treated as well. For my patients I normally use 2-4 units per side in the DAO or mentalis (4-8 units total). Fifteen units is a higher dose than I use therefore the results or adverse effects may last longer than the usual 3-4 months. It is important to understand that effects from Botox are not permanent and patience is important. Please consult with a doctor for specific recommendations.
Good luck!

Keith Denkler, MD · Answer

Sorry about the prolonged recovery.  Botox is not permanent and does wear off. Higher doses take longer to wear off and you should be reaching the limit of the Botox effect.Best wishes and hang in there.

Zachary Farris, MD, FACS · Answer

Sorry to hear about your situation.  The good news is that Botox is not permanent and the effects should be wearing off soon.  Be sure to discuss your concerns with your injector.  Good luck.

Melvin Elson, MD · Answer

15 units is a high dose for this area, but it should be about gone at this point.  If not it will be gone very soon and if you desire treatment again try getting Botox and a filler in the area.