Muscle Stimulation Machine to Get Rid of Botox?

Question

A doctor overinjected my masseter muscles with botox (he almost might have gone too low on my crows feet, I'm not sure which) and now I can't really smile on one side of my face; instead of curving upwards, my lip moves straight out horizontally and my cheeks don't lift. He suggested coming back into he office for some sort of machine (it might be a laser) that should stimulate the muscle and thus help break down the botox more rapidly. Is this a legitimate strategy?

Otto Joseph Placik, MD · Answer

There are several confusing issues here which don't make sense. If you inject the crow's feet and place the product two deeply, the botox could spread to the zygomatic muscle which would effect smiling. Injecting the Masseter does not truly alter one's smile. More active muscles tend to dissipate the toxin more quickly but I am not aware of any study which suggests that extermal stimulation of the muscle will expedite diminution of the botulinum's effect. These devices are used to maintain muscle bulk following denervation injuries to the facial muscles.

Donald B. Yoo, MD, FACS · Answer

The machine is unlikely to help break down the botox more quickly. Botox blocks nerve conduction at the neuromuscular junction, and until new synapses "sprout", the treated muscle is paralyzed. These new synapses form in 2-6 months. Your smile symmetry will improve as the effects of Botox wear off, but unfortunately there is not way to expedite this process.

James M. Ridgway, MD, FACS · Answer

Botox is a purified neurotoxin that strongly binds with proteins to deactivate the messaging system between nerves and muscles. It does so, with such efficiency, that it is used in clinically to treat muscle spasticity. These patients’ muscles return to normal function (loss of Botox effect) at the same rate as average individuals without overstimulated muscles (muscle spasm). Unfortunately there is no immediate fix for your condition. However, the best remedy for your current condition is time – at most 4 months.Be healthy and be well,James M. Ridgway, MD, FACS

Michael A. Persky, MD · Answer

Hi Lapcas,

	Not aware of any machine that can stimulate muscles that are paralyzed by Botox.  I would be very skeptical.  Perhaps physician is counting on the placebo effect.  Like chicken soup, it can't hurt (unless you are charged for the "treatment").  Hope that your muscles return to normal quickly.  Good luck and be well.

	Dr. P

	Los Angeles. CA

Paul Vitenas, Jr., MD · Answer

Unfortunately, I am not aware of any machine that has been reported to accomplish this. I assume what you are referring to is a TENS unit which has been used to stimulate muscle activity in muscles that have lost nerve innervation due to stroke, etc. For this to be effective you will have to use it many times and for an extended period of time. The good news is that your condition is temporary and will resolve itself in a month or so.

Steven Wallach, MD · Answer

Muscle stimulation machines do not reduce the effects of Botox.  Botox takes about four months to breakdown.

Sam Goldberger, MD · Answer

Hello Lapcas.

	I have not heard of a machine that will get rid of Botox.  Botox paralyzes muscles by blocking certain receptors on the muscle.  You must wait until your body creates new receptor sites for the muscle to function again.  This takes between 3 and 5 months in the areas where the Botox was injected and often less time in the areas where the Botox "traveled" to.   Ultimately, it goes back to the way it was by 3 to 5 months.

Emily Altman, MD · Answer

There are ways of stimulating muscle by direct appication of electrical current.  That would cause a muscle twitch or slight contraction at the moment of the application of the current, but it does not break down Botox or reverse its effects.

	Botox binds very tightly at the neuromuscular junction and prevents the signal from the nerve to the muscle to contract.  A muscle stimulation machine can cause the muscle to contract momentarily but does not do anything for the blockade of the signal that botox causes.

Catherine Huang-Begovic, MD, FACS · Answer

I've never heard of this type of machine and I think many of my colleagues would agree.  Also, the science behind how botox works also contradicts this type of machine.  The machine may stimulate the muscle but I doubt is breaks the Botox down.

	Dr. Cat Begovic M.D.

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