Is there anything i can do to correct an asymmetrical smile after Botox?

Hello, when I smile I've a dimple on my left cheek and not on the other one, my cheek therefore my left nostril goes higher than the right one which cause an asymmetry on my face. My nasal bridge tends to deviate a bit on the right, don't know if it's the reason. (I got botox 2 months ago if it can help).

Doctor Answers 5

Asymmetric smile -- before or after Botox?

I am not absolutely certain from your question whether you had some facial asymmetry before the Botox, or whether you only noticed it after the Botox. You also don't say where the Botox was injected. 

Especially if you had some Botox injected for smile lines around the eyes, it is possible that some of the Botox migrated to muscles other than those the doctor intended to relax.  If so, you should visit the doctor now so that she or he can make any adjustments that might be possible, or at least alter the protocol for the next Botox session.  These problems are not at all common, and could easily be avoided on the next go-around. Be assured that whatever you don't like will resolve fairly quickly.  I like to use very concentrated Botox to keep it from diffusing where i don't want it to go.  This results in a bit more of the Botox being wasted, but saves my patients from having an unexpected result.  I also prefer to  use lower doses the first time a patient is having an area injected, and top it up if necessary than to use too much up front.  Dysport may diffuse more than Botox or Xeomin, so I tend to use Botox for small muscles or where exact placement is critical.  Studying the anatomy of the face in depth is very helpful as well.  Every patient gets injected in a different pattern based on the size and arrangement of their muscles and facial features, because no one face is exactly like another, and above all, one wants the result to look natural.  Someone else should not be able to tell you have been treated.

All of the botulinum toxin A's (BTX-A), including Botox, can be used to correct some facial asymmetries. Most patients in fact, do not have an exact mirror image of one side of the face to the other. Try this: put a piece of paper exactly over the right half of your face, and look in a mirror at the left side of your face.  Then cover the left side of your face, and look at the right side of your face.  Most people will notice some differences.  Sometimes, a patient is not aware of these differences until after BTX-A is injected when they are scrutinizing the face more carefully.

New York Dermatologist
5.0 out of 5 stars 8 reviews

Asymmetry After Botox

Botox can be used to correct facial asymmetry or cause some facial asymmetry.  Without photos and knowledge of the injections it is difficult to comment.  I would return to your treating dermatologist for consultation and look at your before and after photos as well.

Michele S. Green, MD
New York Dermatologist
5.0 out of 5 stars 78 reviews

Botox caused funny smile

  • It isn't clear where the Botox was injected and whether your face was asymmetric before then.
  • Botox injections for crows feet, lip lines and TMJ can affect muscles that change the smile.
  • The effect wears off as the Botox wears off - about 3-4 months. Best wishes.

Elizabeth Morgan, MD, PhD
Atlanta Plastic Surgeon
4.6 out of 5 stars 43 reviews

Uneven Smile After Botox

Thank you for your question. It's impossible to say without photographs.

It sounds like you may already have had some facial asymmetry.

Either way, the Botox will wear off completely in 3-4 months and your facial muscle function will return.

To be sure, see two or more board certified and experienced plastic surgeons in your area for a full and complete evaluation.

I hope this helps.

J. Jason Wendel, MD, FACS
Nashville Plastic Surgeon
5.0 out of 5 stars 183 reviews

Botox for Crooked Smile

Thank you for the question. Botox can be very useful in correcting subtle asymmetries in facial movements. In non-cosmetic settings, it is actually used for patients with nerve damage on one side.  That said, injecting Botox around the mouth requires accuracy and precision... and even then, can have a negative effect on speech, chewing, swallowing, etc.

Evan Ransom, MD
Bay Area Facial Plastic Surgeon
4.9 out of 5 stars 113 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.