I cannot smile after Botox and Fraxel Laser. Is it nerve damage?

Question

Botox was injected underneath my mouth in the frown areas and under my eyes and between my eyes right before the Fraxel. For the first two weeks I couldn't lift my upper lip at all when trying to smile and the corners of my mouth are uneven when I smile. Its eased a little bit but is causing me to be depressed and my expressions just look weird. I'm so afraid I'll never get my smile back. Is it nerve damage from Fraxel or Botox?

Ron Shelton, MD · Answer

Whatever nerve relaxation has occurred after Botox is not permanent. Usually the muscles wake up around 4 months after the treatment. Fraxel is not known to cause any nerve damage. See the physician who injected your Botox for an evaluation.The information provided in Dr. Shelton's answer is for educational purposes only and is not intended to constitute medical advice.  The information provided should not be relied upon as a substitute for consultations with a qualified health professional who may be familiar with your individual medical needs.

Mehdi Sina, MD · Answer

Hi,Neuromodulators such as Botox/Dysport act on the muscles NOT nerves - they prevent muscles from releasing calcium and therefore from contracting. The results are temporary and usually improve in a few weeks and completely in about 3 months. Laser treatments are superficial and never penetrate deep enough to injure nerves. Your issues may be related to poor placement of the Botox but as previously mentioned, they will resolve in time.Best,

Center for Aesthetics and Plastic Surgery - Grand Rapids · Answer

Hello there! I do not think this is nerve damage from what you are describing. I think the neurotoxin injected beneath your mouth has migrated and is affecting your movement in that area. This is a very sensitive area to inject, and only an experienced injector should be treating you here. Also, only small dosages of neurotoxin should be used. The good news is that this is not permanent, and should wear off as the Botox wears off. Usually people notice improvement after a month or so. Good luck! Sarah RN BSN

Brian Kerr, MD (retired) · Answer

Hi there! I'm sorry to hear that you are having a reaction. It is unlikely that it is nerve damage. It sounds like it caused by the Botox injection spreading into areas it shouldn't. The good news is, if this is the case it will wear off in 3-4 months when your Botox does and will continue to improve as your Botox wears off. I highly recommend you see your Botox provider for a follow-up as soon as possible for an evaluation. 
Fraxel laser is highly unlikely to cause any nerve damage.

The information provided in Dr. Kerr's answer is for educational purposes only and is not intended to constitute medical advice.

I cannot smile after Botox and Fraxel Laser. Is it nerve damage?

Answers (4)

Answer: Botox around the mouth

Answer: Botox around the mouth

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I cannot smile after Botox and Fraxel Laser. Is it nerve damage?

Answers (4)

Answer: Botox around the mouth

Answer: Botox around the mouth

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Recommended reading

Everything you need to know about Botox

Our mission is to create a world where every investment in modern beauty is Worth It.