Why is my Smile Still Crooked One Year After Botox for Jawline Reduction? (photo)

I went to a plastic surgeon about a year ago to have botox for Jawline reduction. I've had it done before and the results were great, but this time I told the doctor to inject a little more on the left side than the right since my left side was a little bigger. My smile became crooked - when I smile the right corner of my mouth lifts up more than the left. Could this be nerve damage? Is there anything I can do to fix this?

Doctor Answers 7

Botox and efficacy a year later

Based on the photo's you've provided, your smile doesn't look crooked. Rarely are both sides of the face exactly the same and there are several factors that determine this. Botox doesn't last a year and won't cause permanent damage to your masseter muscles.

Seattle Facial Plastic Surgeon
4.7 out of 5 stars 221 reviews

Uneven smile

Before getting to your question, first and possibly most important, from the limited photo, it appears that you have an attractive smile.  An asymmetric smile can be due to one or more of multiple factors including underlying facial asymmetry, your dental occlusion, or uneven muscle function. Botox would be used to treat an uneven muscle function contribution to your asymmetric smile.  Typically the effects of Botox wear off in 3-6 months.  Therefore at one year it would be surprising to have any residual benefit.

Paul Carniol, MD
Summit Facial Plastic Surgeon
5.0 out of 5 stars 7 reviews

Smile asymmetry from Botox

We could only hope that Botox would last for a full year.  That being said their is no other reason that you should have any asymmetry of your jaw.  I would think that over time this will get better.  

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 19 reviews

Crooked smile after Botox

I have not seen Botox last for a year, regardless of the facial entity in which it was injected. I would very carefully evaluate your before photos and see if this is definitely something that happened after the Botox. What you see, regardless, is very minor, and if it has to do with Botox in any way, it should continue to resolve with time.

F. Victor Rueckl, MD
Las Vegas Dermatologist
4.6 out of 5 stars 17 reviews

Why is my Smile Still Crooked One Year After Botox for Jawline Reduction?

The photo demonstrated issue is very minor but if it bothers you than first step is to return to the injecting doctor to discuss. Next to to allow the BOTOX to metabolize over the course of 3 months. Because BOTOX does not last more than 6 months in all our experiences. Finally do you have a medical or anatomic or genetic reason for this very minor asymmetry in your smile

Darryl J. Blinski, MD
Miami Plastic Surgeon
4.6 out of 5 stars 173 reviews

Crooked Smile after Botox?

Hi Shen.  In the pictures you have provided, the left side of your smile seems to be higher, which is different from what you describe as your concern.  In addition, Botox would be not last a year in this area.  What you are seeing is very likely a concern related to your own facial anatomy rather than the injections.

Harold J. Kaplan, MD
Los Angeles Facial Plastic Surgeon
4.3 out of 5 stars 6 reviews

Asymmetry smile after jaw reduction

It will go away - some of the Botox has diffused at the time of injection and caused weakness of the muscles that control your smile - it is interesting that it has lasted 1 year - but it will improve over time - it is not likley related to nerve injury.

Hratch Karamanoukian, MD, FACS
Buffalo Phlebologist
4.8 out of 5 stars 41 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.