Permanent muscle paralysis after injecting 20 units to whole forehead for the first time?

Dear doctors , Hello... I am very anxious since I am still having feeling of tightness in my forehead ( better slightly) and muscle spasm in my group of myscles at top of my head and at the sides , comeingb in bouts and relapsing but with less intensity . I had only 20 units injected in all forehead , with natural looka d some myscle movementat my sides, Will I have perminant muscle paralysis ?as I can not see any much improvement in my symptoms though I am heading into 4th week? Thank you

Doctor Answers 9

Botox Paralysis

Thank you for your question. Botox is used cosmetically to remove wrinkles by temporarily paralyzing muscles. Though uncommon headaches are possible after Botox injections. This should resolve soon. I recommend contacting your treating physician with your concerns and if this persists. Best of Luck!

Summit Emergency Medicine Physician
5.0 out of 5 stars 45 reviews

Botox paralysis

Hello.  Botox is always temporary, so the effect you've described won't last more than a few months.  This is assuming you have no other medical issues, so if in doubt make sure you consult with your physician as soon as possible.

Reza Tirgari, MD
San Diego Physician
5.0 out of 5 stars 4 reviews

Botox does not cause permanent muscle paralysis

Botox is only a temporary muscle relaxing agent, it is never permanent.  It lasts 2-6 months in the forehead area. Occasionally, adjacent muscle spasms can be associated with the treatment. 

Marla M. Klein, MD
Lake Oswego Dermatologic Surgeon
5.0 out of 5 stars 8 reviews

Botox is temporary

Hi Lubna77,

Not to worry, Botox is temporary and does not cause permanent paralysis. 4 weeks is still quite early, as Botox typically lasts 3-4 months. I know it can be stressful when it is your first time and you are not sure what to expect, but rest assured your forehead will gradually return to its original state. 

David W. Kim, MD
Bay Area Facial Plastic Surgeon
4.8 out of 5 stars 37 reviews

Permanent paralysis from Botox?

Hello Lubna77,

Thank you for sharing your question and concerns. Rest assured that no effects of Botox whether you like them or not are permanent. The effects on average will be gone in 3-4 months, for some can be up to six months but none are permanent. The dosage you describe is not considered "a lot" either. Relax and enjoy your results. 

Paul Pietro, MD
Greenville Physician
5.0 out of 5 stars 3 reviews


None of the effects of Botox either good or perceived bad are permanent so rest assured all will be gone in another couple of months

Melvin Elson, MD
Nashville Dermatologist
5.0 out of 5 stars 4 reviews

How long does Botox last?

The injected Botox will last 3-4 months. It is still fully effective after 4 weeks. 20 units is not an unreasonable dosing for the forehead. 

Steven F. Weiner, MD
Panama City Facial Plastic Surgeon
4.7 out of 5 stars 41 reviews

Botox - is effect permanent

Thank you for asking about your Botox result.

You anxiety is entirely understandable. You had standard dose of Botox. It sounds as though the paralysis is partial (as it should be) and that you are aware of the remaining muscle movement. (Most people are not.).

Botox effects are not permanent. Botox lasts on average 3 months but the range if 6 weeks to a year. Just give yourself time, don't worry and the effect will go away.

Best wishes. Elizabeth Morgan MD PHD FACS

Elizabeth Morgan, MD, PhD
Atlanta Plastic Surgeon
4.6 out of 5 stars 43 reviews

Headache after Botox

Thank you for your question Lubnya. I am sorry to hear about your situation. Botox is a purified protein used to address wrinkles associated with facial expression. Headaches are uncommon but possible after a Botox treatment. Usually they resolve within two weeks. All effects including intended effects and side effects normally resolve 3-4 months after a treatment. If neurological symptoms persist beyond that point another cause is possible and it would be good to visit a neurologist at that time. Please consult with a doctor for specific recommendations. Good luck!

Alex Eshaghian, MD, PhD
Encino Physician
5.0 out of 5 stars 4 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.