I had 20 units of Botox in my chin to reduce chin dimples. My lower smile is lopsided. Frozen on one side, droops on the other

Question

Dr. did 5 units on either side of the chin under the nasal labial fold? and 2- 5 unit shots in the front chin. The left side of lip is pulling up and the right side of my lip is pulling down. don't want to go back to Dr. who did it as he is admittedly not very experienced in this area. Is there a Dr in Bergen/Hudson County NJ that can help straighten out my lower lip with a small amount of botox on the unparalyzed side. How soon will this amount botox START to fade away? Will post pic soon.

Rajat Gupta, MD, MS, DNB · Answer

Botox has gone to the wrong muscle, perhaps Depressor Anguli Oris (DAO) muscle (a muscle associated with frowning that pulls the corner of your mouth/smile down). To correct the asymmetry, Botox the opposite side DAO with 2 units. It will not rectify the current situation but will at least provide symmetry on the face.
Consult a board certified plastic surgeon that can examine your case.

John Paul Tutela, MD · Answer

Thanks so much for reaching out. It is unfortunate to hear your complication. Botox will start to fade after 2 to 3 months and it is best to wait for its effects to wear off rather than treat the other side.I hope this helps :)

Alex Eshaghian, MD, PhD · Answer

Thank you for
your question CLPJK67. I am sorry to hear about your situation. Botox is a
purified protein used to address wrinkles associated with facial expression. In the lower face Botox can be placed in the mentalis muscle to address dimples on the chin and in the DAO muscle to elevate the corners of the mouth. If the Botox spreads to the nearby DLI muscle it can lead to a temporary asymmetric smile. Side effects resolve in 2 weeks - 4 months. Please
consult with a doctor for specific recommendations. Good luck!

Sean Doherty, MD, FACS · Answer

I am really sorry that you are going through this. In all honesty, I don't think that doing more is the answer. I think you should just let things be. Your smile will improve as the Botox wears off. And obviously, if you plan on trying this again, see an experienced injector like a board certified plastic surgeon. It is always worth the money in the long run.

Shaun Patel, MD · Answer

Sorry to hear about your experience but thanks for sharing your question. Honestly, I recommend that you just give the Botox time to wear off rather than get the opposite side injected. You will see some improvement in your smile over the next 4-6 weeks although it can take 3-4 months for the smile to return to normal. Hang in there. The Botox will wear off.

Edward A. Alvarez, DDS - Account Suspened · Answer

Hello, and I'm so sorry to hear that you have had a bad experience with botox in your chin. Unfortunately, by trying to add more botox to the area you will probably end up with more deviation in your smile. As one side starts to wear off, the other will then look more lopsided. Even if you are "evened" out with more botox, your appearance may not improve. The best advice I could give, is to give the botox time to fade. 5 units of botox is actually quite a small amount for strong muscles that move quite a bit, so it should not be more than 3-5 weeks before you see significant improvement. Best of luck for a speedy recovery!!!
-Dr. Alvarez

Douglas Taranow, DO, FACOS · Answer

Sorry to hear about the issues post Botox injection.  Best advice...let it wear off.  Do not add more trying to make it symmetrical.  Usually, it starts to improve in 4 weeks.  It should be back to normal in 2-3 months.Good luck.Dr T

Faiyaaz Kalimullah, MD, FAAD · Answer

I'm sorry to hear that you're experiencing an uneven smile after Botox injections in your chin.  From your description, it sounds like your doctor may have injected your chin too laterally - rather than targeting the mentalis muscle (which creates chin dimples), he may have accidentally treated one of the muscles that pull the lip down, resulting in an asymmetric smile.  Also, 20 units is a high dose for this area - the Botox may have drifted from his injection points to other muscle groups.  
Unfortunately, once the Botox has affected the lip depressor muscles, there isn't much that can be done to reverse it.  It will take up to 3-4 months for the Botox to wear off.  Botox injections in the lower face are an advanced technique and require an expert injector - I would recommend seeing an experienced cosmetic dermatologist in the future.

Steven Wallach, MD · Answer

Chin botox if placed incorrectly or a bit too laterally can cause block of the depressor anguli oris muscle and cause the lip to not function correctly.  You will have to let it wear off to go back to normal

I had 20 units of Botox in my chin to reduce chin dimples. My lower smile is lopsided. Frozen on one side, droops on the other

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