I had 20 mg of Botox injected near my eyes 4 days ago. The tip of my tongue has been numb since. Should I be concerned?

Dear Spyder1313, Thank you for your question. It is highly unlikely that botox would cause you to have numbness in your tongue. I suggest following up with your primary care physician. Best of luck to you!

Thank you for the inquiry and sorry to hear you are having an issue. I do not believe there is any link between the Botox injection and the numb tip of your tongue. I think it is simply one of those unusual coincidences.  Botox affects muscle contractions. If the numbness continues, please contact your primary care MD. Best of luck!

I cannot imagine a way that Botox injected around the eyes could affect the sensation of the tip of the tongue.  Also, Botox affects nerves that control muscular movement and not nerves that control sensation.  I think the tongue numbness is very likely not due to the Botox injection you had 4 days ago.  

This should be unrelated to the Botox injection as the nerve innervating the tip of your tongue is a completely different nerve that the one treated with Botox around your eyes. If symptoms persist, though, you should follow-up with you injector.Best regards and happy holidays,Thomas Walker, MD, FACS

Thanks for the question.  The orbicularis muscle which is treated by Botox in the crows feet, is innervated by the facial nerve, which is a  different nerve than the lingual, which gives sensation to tip of the tongue.  I can’t see any way this could happen.  Give it some time to see if it resolves.  If it doesn’t , see an ear, nose and throat physician.

This is unlikely due to your Botox treatment. If it persists, I recommend following up with your Doctor. It will take 1-2 weeks for final results with Botox. Best, Dr. Emer

Thank you for your question Spyder1313. 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 where the entire medical history is reviewed. 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.The safety record of Botox is well established. The product has been used for over 20 years for a variety of treatments with minimal side effects. Botox is amongst the safest treatments for treating facial wrinkles.While Botox is one of the safest treatments offered, there are some situations where it is not appropriate. These include anyone who has an allergy to any of the inactive ingredients or who has had an allergic reaction to any botulinum product including Botox, Dysport, Xeomin, or Myobloc. The safety and efficacy of Botox has not been established in women who are pregnant, trying to become pregnant, or breast feeding. Therefore, women in these categories are advised to wait until breast feeding is completed prior to having a Botox treatment. Botox should not be placed in the skin on the site of an infection. Those who are taking an aminoglycoside antibiotic, an anesthetic, D-penicillamine, antimalarials, or immunosuppressants should not be treated, nor should those who have undergone chemotherapy within the previous six months. It is important to avoid blood thinners before and after a treatment. These include both prescription and non-prescription medications such as warfarin (coumadin), aspirin, ibuprofen, alcohol, fish oil, vitamin E, and ginko biloba. Those with conditions that affect muscles and nerves such as amyotrophic lateral sclerosis (ALS or Lou Gehrig's disease), myasthenia gravis, or Lambert-Eaton syndrome should not undergo Botox treatments.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.If I had a patient with the concern described here I would say that the numbness in the tongue is unrelated to the Botox treatment and I would recommend consulting with her general doctor.
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!

I do not believe there is any connection between the Botox and tongue tip numbness.  Botox is a neurotoxin, which acts at the junction of where nerve and muscle meet, forcibly relaxing the muscle by disallowing the chemicals released at the ends of nerves to get into the muscle receptor sites (and thereby preventing the muscle from contracting).

Botox affects only muscles and only in the area of injection. it does not affect an area distant from the injection and has no effect on nerves so Botox is not the cause of this problem

Hello
One of the side effects perfectly avoidable if we put ourselves in the hands of a professional is a possible allergic reaction to botulinum toxin: this would produce inflammation in the area of the face and throat, difficulty breathing, urticaria.
Regards.