My smile has completely changed after Botox on forehead, frown lines, crows feet, & under eyes. Any suggestions? (photo)

Thank you for the question and the photo. If the Botox was injected too deeply in the area under the eye and in the upper cheek, it could be affecting one of the smiling muscles (zygomaticus). This will resolve as the Botox wears off. In the interim, you can try massage, warm compress, and facial exercises to try to "wake up" the area. Botox wears off over about 12 weeks.

It could be Botox or possibly filler if you had that as well. It's important to sleep in a proper position the night you have your treatment. I've included a video from my YouTube channel that explains this.You'll have to wait and see how the smile changes over the next few months. If it starts to slowly return to normal, you know that it was possibly the Botox. If you don't see it returning, you may want to consider seeing a doctor to eliminate any other possible health issues. But it is likely a result of your treatment in some way.I wish you all the best with this,Dr. Jerome Edelstein

This is fortunately an uncommon issue. It is likely that the Botox injected around the Crow's feet area diffused into unintended muscles. This can result in heaviness in the upper lip and a lack of lip elevation with smiling. This is temporary and will wear off, hopefully, within a couple of weeks. If you still trust your injector you can return to them. However, you would be best treated by seeing a plastic surgeon of dermatologist injector who truly understands the anatomy of the face and the muscles that they are treating. Good luck!

The effect of the Botox on your smile is a result of poor injection technique. Unfortunately, there is nothing that can be done except for wait for the Botox to wear off. This usually takes 2-4 months depending on how much Botox was given. The good news is that everything should go back to normal once the Botox has completely worn off. Sorry you had to experience this.

Dear Goldfish26:Botox is a miraculous drug when used correctly. It is extremely artful and injector dependent on his or her skills. Thank you for sharing your photos. When Botox or any of the muscle relaxer injectibles is not specifically targeted, adjacent muscles may be affected causing relaxation and therefore an imbalance on facial appearance. It appears that the muscles of your eyelids, your right lower lip and your cheeks received a dose of Botox during your injection session causing your eyelids and upper lip to drop and your right lower lip to raise. The good news is that if minor amounts of Botox reached these muscles, the waiting time for the muscles to return to normal function is shorter than the average 3 months. It will also return to full function.You may consider discussing the eyelid droop with an ophthalmologist as there is a eye drop than can help if seeing is a problem. You may also consider widening the area of placing your lipstick to camouflage the reduction in lip opening.If you have concerns with your injector, consider another opinion by a well experienced, Board Certified Plastic Surgeon or ENT Facial Surgery injector to review these problems. I wish you the best!