Can botox injections permanently injure facial nerve?

Question

I came across an article that was written back in 2010 regarding the actress "Dana Delany" and how she allegedly had a facial nerve that was struck while injecting botox which caused a "permanent droop". I've never heard of this before and assumed all Botox effects are temporary ?

Nelson Castillo, MD · Answer

Thank you for your question, and  I can understand your confusion.  Botox itself does cause temporary results, as seen by the return of wrinkles when no longer effective in a particular location of the face.  Botox's administration, however, may have unintended effects that may have longer lasting consequences.  This would be an extremely rare case, but I suppose it is possible for the needle used to inject Botox to strike a branch of the facial nerve, or an accidental injection of Botox into the nerve to injure it.  Only for emphasis, but this would be extremely rare and unfortunate as there are methods that can be used to avoid an inadvertent injection into important facial structures.  This is an example of why it is always wise to see a board certified medical specialist for even minimally invasive procedures such as Botox administration.

Jason Emer, MD · Answer

Botox cannot permanently damage nerves even if injected into them.  I suggest seeing a cosmetic dermatologist or plastic surgeon with experience.  Best, Dr. Emer.

William Marshall Guy, MD · Answer

Hello Nickj,The nerve that controls the facial muscles starts just below your ear and fans out across your face going from deep to superficial.  The closer to the middle of the face you get the more the nerve branches and reconnects meaning multiple nerves help to stimulate the muscles.  The nerve itself is about 3 millimeters wide at its largest and then gets progressively smaller towards the middle of the face.  As a surgeon there are particular surgeries that I have done that required me to trace these nerves out along their length so this provides an excellent understanding of the facial nerveHaving described all of that, the needles used for injections are very thin.  So even if the nerve was accidentally hit, the chance of any permanent damage is essentially unheard of.  The only place it would be at risk is an area that is not injected for cosmetics (around the parotid gland for sweating with eating) and only then if the needle was placed way too deeply.  Without reading that article I cannot comment specifically on it but you are correct, the effects of Botox are temporary.  They tend to last about 3 months.  Prior to any injection, you should discuss the risks with your physician.I hope this helps and good luck.

Todd C. Miller, MD · Answer

Hi Nickj, it would be exceedingly unlikely that Botox injection would cause any type of facial nerve injury let alone permanent injury.

Anthony Youn, MD · Answer

Botox would be extremely unlikely to cause permanent damage to a facial nerve. He needle is so tiny, and the results are temporary. The only way I can think this might happen is if a large needle was used and the needle caused the damage. But very doubtful and unlikely.

Can botox injections permanently injure facial nerve?

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Answer: Botox and facial nerve injury

Answer: Botox and facial nerve injury

Answer: Botox and facial nerve injury

Answer: Botox and facial nerve injury

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Can botox injections permanently injure facial nerve?

Answers (10)

Answer: Botox and facial nerve injury

Answer: Botox and facial nerve injury

Answer: Botox and facial nerve injury

Answer: Botox and facial nerve injury

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