Is Botox and Voluma in the cheeks affecting my smile? (photos)

Question

48 hours after receiving 15 cc Botox and 1 cc Voluma in each cheek, I noticed tightness in my right cheek causing my lips to not fully pull up in the right corner. This makes my smile asymmetrical. I had 1 cc of Juvederm injected in each cheek 7 months ago and liked the results. I wanted more smoothness in my cheeks when I smile so I revisited the same board certified doctor who suggested Botox this time. When should I call the doctor with my concerns? Can my smile be corrected?

Edwin C. Pound, III, MD · Answer

I can understand the reasoning behind placing fillers in the cheeks to add more volume.  I don't know what the goal was in putting Botox in the cheeks.  Botox inhibits muscle action and there are several muscles in the cheek area which elevate your lips.  My guess is that it was the Botox, not the filler, that is affecting your smile.  Fortunately, the Botox will wear off after awhile and you should regain your normal smile.

Brian Coan, MD, FACS · Answer

Thanks for sharing your photo and questions. While some patients can notice tightness after
receiving Botox and fillers, we generally like our patients to wait a full
10 days before doing any corrections or changes.  It would be helpful to
know exactly what was placed where.  It is great that you had the
injections performed by a board certified plastic surgeon or dermatologist and
my recommendation would be to see them and speak with them directly after 10
days.  Best of luck to you!

Steven F. Weiner, MD · Answer

It is incorrect to place Botox in the cheek. This will affect the zygomaticus muscle and affect movement of lip and position of cheeks when smiling. Also, asymmetries of cheek could be due to the Voluma placed poorly. Botox will wear out in 3 months but the filler will take a year or longer. Discuss with you doc and form a plan.

J. Randall Jordan, MD · Answer

From the photo- it looks like
the right cheek is lower. This could be from the placement of the Voluma&trade; or from
muscle weakness form the Botox&trade; injection. You should return to the doctor who
injected you and yes, it may be possible to correct the smile, or it may go
away on its own over several weeks if it is a side effect  from the
Neurotoxin injection.

Mats Hagstrom, MD (license on probation) · Answer

It is possible to have the smile affected by Botox injections.This typically happens when crow's feet lines are injected too far out and down.The main smile muscles are called the zygomaticus.These muscles attach from your cheekbone just underneath those outer smile lines, or crow's feet.When treating crow's feet in this area, Botox injections should be done in very small amounts and very close to the skin surface.If Botox was injected in the forehead or frown lines, then it is unlikely this had any effect on your smile.Best of luck,Mats Hagstrom, M.D.

Is Botox and Voluma in the cheeks affecting my smile? (photos)

Answers (5)