Skewed smile after Botox injections in smile muscles for essential tremor (photos)

I'm sorry to hear of the concerns you have from your Botox treatment. Botox effects are temporary. for most patients the results wear off gradually over three to four months, although it may be longer for some people.

For unique cases where a variety of modalities could be used to treat the condition, I would suggest an in-person or virtual consultation to develop a custom and effective treatment plan. It is difficult to precisely define the best option without collecting the same information. I suggest reaching out to an expert for a consultation with surgical and non-surgical methods to get a comprehensive option. Best, Dr. Emer.

Botox usually works for only 3-4 months, but as the muscles are weakened with the treatment it may take a few more months for the muscle to fully regain its strength.
Be well,
Christopher Lo, MD

Hi and welcome to our forum! From your photos, I note moderate droop of the affected side of your upper lip. Botox (botulism toxin) causes localized temporary muscle weakness or paralysis by binding to nerves supplying the muscles and interfering with electrical signal transmission to the affected musculature. Once bound, it cannot be reversed. However, its effect wanes over a period of 3-6 months. If severe, injection of a few units of Botox to the opposite side of the upper lip may improve appearance but may affect speech. It may be best to allow spontaneous resolution.Best wishes...