Botox for facial asymmetry due to nerve damage? (Photos)

Question

I underwent Accutite for my jowls along with Morpheus on my lower face/neck. For 6 weeks I was left with the inability to properly move my upper right lip when puckered or pronounced “O” and “P” words. It is slowly improving but I am now experiencing assymmetry. There is a dimple forming and my nasal labial fold is higher on the “paralyzed” side. I can also still feel some tenderness next to my nose. My right nostril doesn’t flare the same as the left. I’ve done a round of steroids. What’s next?

Jason Emer, MD · Answer

This is my expertise and a huge portion of my practice. Asymmetry is normal and expected. Buccal fat pad gives slimming not symmetry. Masseter botox will make you slimmer and make the jawline more loose. Fillers help give shaping and contouring. If you want perfect or close to perfect symmetry you need maxillofacial surgery or implants customized. I suggest seeing an expert to go through all options. Most of my younger clients use fillers to give them shaping especially on the cheeks, jawline, and chin which make the face look more slim and tight; and threads such as PDO or Instalift can build collagen and support the facial shaping and skin looseness over time, slowing down the aging process and given the face a more “snatched” look; and morpheus8 or PiXel8 deep microneedling RF can tighten crepe skin especially on the neck and jawline and is great for long term tightening of the full face, neck and chest; its often used to give the face a slimmer more sculpted look because it tightens the skin and gives lift. an early face lift can be performed as well even in younger clients if they want a different facial shape, maxillofacial surgery with bone breaking or shaving can also be done. For facial slimming a combination of treatments are always needed. Options include: 1. Buccal fat pad removal to reduce fat on the lower face 2. Factite or Renuvion/J Plasma to tighten the lower face, jawline, and chin to reduce fat and give the jawline and neck tightening and shaping. 3. Botox to the masseter to reduce the muscular size of the jaw giving the face an illusion of being more slender 4. Fillers to the jawline, chin, cheeks, temples and brow help to shape the face and make it more angled and defined Always use at home derma rolling (see link to Emerageskin x anteageMD roller plus stem cells/hyaluronic acid ampules) and peels like emeragecosmetics enlighten or aerify that can be used to improve skin quality and tighten the skin while improving wrinkles, pigmentation, acne, and Melasma. See an expert who does facial shaping with surgical and non surgical methods to get a comprehensive option. Best, Dr. Emer.

Jose A. Munoz, MD - Account Suspended · Answer

Hi and welcome to our forum!It is important to know how long it has been since your procedure as complete nerve regeneration may take 18-24 months (or occasionally even longer!). Neuropraxia involves a transient loss of nerve conductivity following injury but no loss of nerve physical continuity. It will usually begin to resolve within 6 weeks. Axonotmesis occurs if the nerve is disrupted but its sheath is intact. Nerve regeneration will occur over time, but the end result may be imperfect.Neurotmesis is complete nerve transection. There will be no return of function.Electrodiagnostic tools are available to differentiate among these entities. If neurotmesis is diagnosed, repair is indicated. Otherwise, one will usually recommend watchful waiting for signs of functional return, which will occur slowly over time. As you are demonstrating signs of partial return of function (assuming it has been less than several years since your procedure), I recommend continued follow up care with your surgeon. Facial exercises in front of a mirror may be of benefit.Botox is a muscle paralyzer. I don't recommend its use while you are still recovering from your last procedure.Best wishes...

Botox for facial asymmetry due to nerve damage? (Photos)

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Botox for facial asymmetry due to nerve damage? (Photos)

Answers (2)

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Everything you need to know about Botox

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