6 units of Botox under each crows feet. My smile was affected

Question

2weeks later when i smile 'y face is distorted: my upper cheeks puff up and my smile is less broad..and the cheeks when smililng are uneven? How long to return to normal?

Nelson Castillo, MD · Answer

Thank you for sharing your question and I am sorry to hear of your Botox side effects.  If Botox is placed too low below the crow's feet it can paralyze the muscles responsible for smiling, resulting in a facial imbalance.  As with all Botox effects it may take up to 3-4 months for this to resolve.

Nelson Lee Novick, MD · Answer

I am sorry that you are having this problem. I have been using Botox for aesthetic purposes since 1991. In my experience, what you are describing may occur when Botox (or the other muscle relaxers, Dysport and Xeomin) are injected too low onto the cheek or if some should diffuse down onto the cheek and affect the muscles of facial expression responsible for smiling. In such a case, not only may the smile be affected, but it may be affected somewhat asymmetrically, as in your case. While, unfortunately, there no injection to reverse the effects of Botox, the results are happily temporary and last only until the Botox is metabolized away--usually somewhere between three and seven months, given individual variations. In many people, the undesirable effects often improve significantly even after only two months or so. Going forward, you would do well to seek consultation and treatment by a board certified aesthetic physician with expertise in the use of Botox.

Richard Zienowicz, MD · Answer

You should consider finding a referral to a new injector to see what if anything can be done to correct the asymmetry of your smile. Otherwise you will need to wait 3-4 months for your smile to return to normal. Thanks

Jason Emer, MD · Answer

Botox can take 3-4 months to wear off. In the mean time, venus legacy treatments may help soften the results and a touch up of Botox and/or filler may help improve the asymmetry. See an expert. Best, Dr. Emer

Andrew Campbell, MD · Answer

When crows feet Botox effects the smile, it was either placed to low on the face, too deep, or both. This unwanted side effect will usually resolve prior to the full 3 months that Botox typically lasts. Andrew Campbell, M.D.Facial Rejuvenation SpecialistQuintessa Aesthetic Centers

James R. Gordon, MD, FACS, FAAO · Answer

Thank you for sharing your concerns. Misplaced Botox can change the appearance of the smile. It typically wears off wishing a few months..  Good luck,

Monika Soni, MD · Answer

Thank you for your question. I am sorry this has happened to you. This is due to your Botox being placed too low below the crow’s feet and paralyzing your zygomaticus muscles (smile muscles). Unfortunately, Botox takes 3-4 months to wear off. I recommend you seek out a new injector.

Hardik Soni, MD · Answer

Thank you for your question. I am sorry this has happened to you. This is due to your Botox being placed too low below the crow’s feet and paralyzing your zygomaticus muscles (smile muscles). Unfortunately, Botox takes 3-4 months to wear off. I recommend you seek out a new injector.

Sanjiv Kayastha, MD · Answer

On average it takes three months for Botox to wear off. Speak with your injector. They may be able to modify your appearance to improve symmetry with additional Botox.

Joseph Doumit, MD · Answer

Hello , sorry to hear about your experience .It looks that the procedure was no done properly. Botox wears off 3-4 months and everything should come to normal. You can verify with your injector to see what he recommends.

6 units of Botox under each crows feet. My smile was affected

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