Can’t smile after Botox & filler (Photo)

Question

Had Botox on forehead frown lines & crows feet & filler in nasolabial folds. After 5 days had lopsided smile Dr said Botox hadn’t taken on the Right side of chin so did more Botox on that side & told me to massage that side to work quicker. Wasn’t aware even had Botox in chin. it’s now 4 days later & I can’t smile I’m devastated please advise on why this happened & how to correct it will face exercise help as I do tv work & had to cancel all work.

Deborah M. Longwill, DO · Answer

Xxxsuzixxx, facial dropping is a complication that can occur when Botox or fillers are injected incorrectly. This is also a recognized complication that may occur when Botox is injected in the lower face. Prescribed by a doctor oral Prednisone can help. I would suggest you follow up with a dermatologist for further evaluation. Best of luck.
Dr.Longwill

Nicholas Gentry, MD · Answer

It appears to me that your Botox migrated from where it was intended or was injected in the wrong place. This has weakened the muscles that help you smile. Botox usually lasts about 3-4 months and everything will return to normal. I would follow up with your injecting physician ASAP

Dan Ilkovitch, MD, PhD, FAAD · Answer

it is likely that Botox that was injected into crows feet diffused and affected the smile lip raising muscles (zygomatic muscles).  The good thing is that Botox is temporary and this will wear off.   For the future you may need to use less Botox to the crows feet, or make sure the doctor is aware of what happened and places it more laterally, or just avoid treating this area since you are worried about your job.

Richard Brighton-Knight, MBChB · Answer

Hi
From the photos, this looks like the Botox has drifted into other muscles around the mouth and changed the muscle function. This is a recognised complication of Botox in the lower face. In the lower face the muscles are smaller and closer together so issues with Botox drift are more common. 
In terms of lasting, because smaller doses are used the effect may wear off more quickly than the overall Botox effect, but it can still last a few weeks. The best advice is to keep moving the area as much as you can to encourage the muscle movement to return.
If this is from a filler injection without any Botox then the cause is different, so i would check to see if he did actually treat the lower face with Botox.

Rita Rakus, MBBS - Account Suspended · Answer

Thanks for your question Suzi. Unfortunately it seems that the toxin you had injected has migrated to the wrong muscles of where it was intended. This could be because you had slightly too much at the wrong depth. This asymmetry will wear off to a cosmetically acceptable level within a month but may take up to 3 months to entirely resolve. Facial exercises will not help due to how the toxin works in the muscle. Always seek a qualified and experienced injector

Can’t smile after Botox & filler (Photo)

Answers (5)

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