How can I regain muscle control after Botox in crows feet caused a lopsided smile? (Photos)

It is  best to avoid further injections until this dose of Botox wears off. It will improve in 2-3 months. Keep smiling, it will stimulate paralysed muscle to create new motor plates faster. It  doesn't look that asymmetric to a casual observer! Be patient. Good luck.

Hello KtLdn,
Im sorry to hear this, It may be that the injection point was slightly deep and it has hit your smile muscle. The effects should wear start to wear off from approximately 4-6 weeks. I would recommend that you follow up with your injector and let them know what has happened. A review in person would be the best way to do this. Monitor that you do not experience any other changes in your facial expressions over the next few days just to rule out other causes. 
Wishing you all the best 

I'm so sorry about your uneven smile after Botox. Your Botox dose is rather small and you should recover sooner as opposed to taking longer to regain muscle function of your smile muscles. I would strongly suggest a full evaluation with you injector for a better assessment of time to recover. 
Best. Dr. ALDO 

It seems as though some of your Botox affected your zygomaticus muscle, but thankfully it is not completely paralyzed. In this scenario, I would not suggest paralyzing the other side for symmetry. Your smile may not be as bad as you think, and it will become symmetrical sooner than you expect. Wishing you well. Dr Joseph

Thanks so much for reaching out. With Botox the only option is to wait it, usually lasts about three months. I hope this helps :-)

Unfortunately, there is no easy way to reverse the effects of Botox.  It is quite common for Botox to have a slightly exaggerated result initially, only to even out within a week or two.  Give it time and I suspect that things will improve gradually.

Thank you for your question and for sharing your photographs KtLdn. I understand your concern. Botox is a purified protein used to address wrinkles associated with facial expression. When injected into the skin Botox will relax the muscles and smoothen out the overlying wrinkles. The most common areas of treatment are in the upper face. These include the horizontal lines seen on the upper forehead when one raises the brows, the vertical lines seen between the brows when one frowns (frown lines), and the crow's feet seen around the eyes when one smiles.It is difficult to make an assessment without a formal exam in the office where I can view the skin in multiple angles and observe wrinkles formed with facial expression. However, I hope the information provided here is useful.The pivotal studies used 24 units of Botox (12 units per side) to address the crow’s feet. These studies demonstrated that the peak results are seen 14 days after the treatment and most people enjoy their results for 3-4 months. At that point, a maintenance treatment is recommended. While some people start to see results as early as the next day, it can take two weeks for full results so patience is important. We have our patients return two weeks after their treatment to assess their results via photographs. At that time additional units may be added if necessary.In the mid face, the zygomaticus muscles sit just below the orbicularis oculi muscle which is treated to address the crow’s feet. When smiling, the zygomaticus muscles pull the corners of the mouth upward. If Botox spreads from the orbicularis oculi muscle downward toward the zygomaticus muscles, these muscles can also become relaxed, leading to the appearance of an asymmetric smile. This side effect resolves on its own in 2 weeks to 4 months, depending on the severity. Some find that laser skin tightening treatments using infrared light or radiofrequency may speed up the resolution process.If I had a patient with the concern described here I would reassure her that this side effect would resolve and to try to be patient.With any injection, there are risks such as pain, bleeding, bruising, redness, swelling, tenderness, and infection. We take special precautions to minimize these risks such as using a painless technique. We also treat bruises with a laser as early as the next day. Bruises usually resolve within two weeks if untreated. After a laser treatment bruises usually resolve in 1-3 days, but may still take two weeks for full resolution. In addition to these risks, with Botox there is also a risk that the product spreads or diffuses to nearby structures. Spread to nearby muscles can lead to side effects such as the temporary appearance of droopy eyelids or a temporary asymmetric smile.

After a Botox treatment, I recommend that my patients avoid heat exposure, alcohol consumption, and strenuous exercise for 24 hours and not lie down flat for four hours. This is because all of these activities may possibly lead to the movement of the product and consequent side effects such as droopy eyelids. Although there have been no definitive studies shown that these actually occur and some physicians do not provide such aftercare instructions, in the absence of data I err on the side of caution and recommend that my patients avoid such activities.

Please consult with a doctor for specific recommendations. Good luck!

Thank you for your question! It is rather unfortunate what happened to you but the most common reason it happens is that the needle went a little too deep into the smile muscles of the face. Your smile may get better over the next 2 to 4 weeks but the full effect of botox will take three to four months to wear off. Best of luck!

thank you for your question. Unfortunately your injector has gone too deep and inject the smile muscle( zygomaticus major). The botox effects will wear off. Don't  fiddle with it as it could make things worse. Your injector would want to know what has happened . Please talk to him/her . Give it time . Good luck

Thank you for your question and photographs.  Botox cosmetic injected into the glabella for frown lines and into the lateral orbital rim would not affect muscle contracture in the lower face.  That being said, you have noted a difference in your cheeks.  My advice is to return to your injector for an evaluation.  He/she may be able to adjust a Botox dose to the unaffected orbital rim for better balance.  Best of luck.