Nervous About my Botox. 5u Each Side for Marionette Lines. What's the Worst That Can Happen?

hi there, i recently had botox for my marionette lines, well i didnt really have any lines but my muscles were well worked and had very prominent shadows around my mouth, when you touched the muscle is was as solid as a brick!! think im a bit stressed and pull my mouth down at times as it was getting achy!! i had 5u on each side of the depressor muscle??? whats the worst that can happen because now im worried and a bit nervous that i might look like the joker or wont be able to speak...thanks

Doctor Answers 5

Botox Risk Minimal

Honestly, if the Botox is placed in the proper area in that amount, nothing.  The Botox should relax the depressors, of the mouth, allowing the muscles that elevate the corners of the mouth to lift and reduce the Marrionette lines.  However, if these are deep because of Jowls and excess fat and loose skin, the effects will be monimal with Botox alone.  It may require a filler like Perlane or a minimum incision face Lift to tighten loose muscle and skin.

Beverly Hills Facial Plastic Surgeon
4.6 out of 5 stars 24 reviews

Never ask what is the worst that can happen?

Never ask: What is the worst that can happen? Because the answer will always be death. A more appropriate question is: What is the most likely complication? The answer to this will be overcorrection, undercorrection and asymmetry. Some people complain of a stroke like appearance.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 81 reviews

Botox to eliminate the downturn of the corner of the sad mouth

Botox injected into the depressor anguli oris will help minimize the pulling down of the corner of the mouth. I have never heard of a "Joker" like effect where the corner of the lip was raised after Botox.  If one side does not work as well as the other, you can readjust the less affected side in a couple of weeks.

Ronald Shelton, MD
Manhattan Dermatologic Surgeon
4.9 out of 5 stars 37 reviews

Botox to corners of mouth

The worst case scenario is an asymmetrical smile for 3 months.  The target muscle is the DAO or the depressor anguli oris.  Relaxing this muscle will soften the marionette lines, but can also cause some asymmetry. 

Louis M. DeJoseph, MD
Atlanta Facial Plastic Surgeon
4.9 out of 5 stars 29 reviews

Worst: asymmetrical smile

The DAO muscle is the target. If some of the Botox diffuses into the DLA muscle, an irregular smile will result. If that happens, however, it can be improved with a little more Botox to the stronger side. This technique works best if combined with filler, or a light tightening device.

Mary P. Lupo, MD
New Orleans Dermatologist
5.0 out of 5 stars 18 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.