Can a drooping mouth from Botox injections be permanent?

My MIL has had Botox injections for a twitching eye for many years. Initially, no problem, but following one set of injections some 10 years ago, her mouth showed a distinct droop. Her dermatologist stopped injecting into her cheek on subsequent sessions, but the droop has remained, and increased. All information would suggest this unfortunate incident should have corrected itself by now, but it has not. Could this damage be permanent ? After 10 years, I suspect it is !

Doctor Answers 6

Most people enjoy their results for 3-4 months

Thank you for your question tellmemore. Botox is a purified protein used to address wrinkles associated with facial expressions. Most people enjoy their results for 3-4 months. Any effect, intended or unintended, lasting much longer than that are unlikely a result of Botox. Please follow up with your doctor for specific recommendations. Good luck!

Encino Physician
5.0 out of 5 stars 1 review

Can a drooping mouth from Botox injections be permanent?

Thank you for your question. It is unlikely the mouth drooping is a result of a Botox treatment. Perhaps obtaining a second opinion is required, the effects from Botox should wear away 3 months after treatment. 


Martin Jugenburg, MD
Toronto Plastic Surgeon
4.9 out of 5 stars 449 reviews


This is unlikely the result of botox.  She should see a neurologist or a head and neck surgeon to be evaluated for nerve damage or a possible mass in the skull base or parotid.

Jesse E. Smith, MD, FACS
Dallas Facial Plastic Surgeon
4.8 out of 5 stars 24 reviews

Botox is gone in a few months

The effects of Botox would be gone after a few months. This looks like a neurological proplem that has progressed and I would have your MIL see a good neurologist

Jo Herzog, MD
Birmingham Dermatologist
5.0 out of 5 stars 18 reviews

Can a drooping mouth from Botox injections be permanent?

Hello Tellmemore,

Having eyelid twitches progressing to a facial droop indicates your mother in law likely has an issue with the nerve that controls the facial muscles.  This issue would be unrelated to Botox.  She needs to see an Ear, Nose, and Throat physician for an evaluation.  The problem could be in her parotid gland (a large spit gland on the cheek) or in her skull.  These are the most likely scenarios for her clinical issues.  In either way, getting evaluated sooner rather than later is advised.  

I hope this helps and good luck.  

William Marshall Guy, MD
The Woodlands Facial Plastic Surgeon
5.0 out of 5 stars 27 reviews

Botox and never damage

The effects of Botox are temporary, and typically last 3-6 months.  Your MIL can have a whole host of other issues contributing to a facial droop.  I think she would do well in meeting with an Ear, Nose, and Throat physician for further work-up.  A thorough consultation, physical exam, and possibly some neurological testing may go a long way in figuring out the cause of her findings.  Good luck! 

Inessa Fishman, MD
Atlanta Facial Plastic Surgeon
5.0 out of 5 stars 4 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.