When I smile my neck muscles are prominent, is this due to the botox?

Botox on my chin ruined my smile. very lopsided. I also notice when I smile my neck muscles are prominent, is this due to the botox? Two cords stick out. Also would chin botox cause the top lip to snarl on one side? Its been 4 and a half months already, and although relaxed a lot from initial injection, when should it go away?

Doctor Answers 8

Asymmetric smile after Botox in the chin

Thank yo u for your question buttercup213. I am sorry to hear about your situation. Botox is a purified protein used to address muscles associated with facial expression. When injected into the chin Botox can soften dimpling on the chin. If it spreads to the neighboring DLI muscle, a temporary asymmetric smile can result. This lasts up to three to four months. Botox can also address and smoothen out neck bands. Often times when one area is corrected another feature becomes more visible. Botox in the lower chin can spread to neighboring muscles as discussed. But muscles affecting the upper lips are not near this muscle in the chin. Please follow up with your doctor for specific recommendations. Good luck!

Encino Physician
5.0 out of 5 stars 1 review

Neck Muscles prominent

Thanks for your questions.  Botox injected into the chin will not make the bands in your neck more prominent.  Botox can be injected into these bands to soften their appearance.  Botox injected into the chin would not affect the top lip.  Botox generally wears off in the 4-6 month period.  Hang in there and consider that you consult with an experienced injector.  I wish you good luck.

Unintended consequences of Botox

Dear buttercup213:

The use of Botox or any other injectible or procedure does not work in isolation. Botox has a diffusion factor which can affect adjacent muscles and relax them as well. By relaxing a set of muscles, it can unmask and make more prominent the visibility or actions of other muscles and/or underlying asymmetries as you have discovered. 

For this and so many other reasons, it is best to consult with a Board Certified, talented Plastic Surgeon who is experienced in all aspects of surgical, non-surgical and minimally invasive options to see what is best for you. 

Your concerns will continue to recede. The average muscle activity return following Botox is 3 months. If your snarl persists, consult with a Plastic Surgeon or ENT surgeon for evaluation. 

All the best!

Dean P. Kane, MD, FACS
Baltimore Plastic Surgeon
4.8 out of 5 stars 69 reviews

Botox issues

I would like to know what Botox dr Rivera uses that lasts 6-8 months. Now as to you concern sorry to hear your issue. Yes, chin injection may cause asymmetries if the the technique is not impeccable but it will go away once the Botox effect is gone ( 3-4 months ). As to the neck bands they are not caused by the Botox in the chin. In fact they could be helped by Botox injection , one of my favorite treatments. Thank you for your question.

Andrew Pichler, MD
Sacramento Facial Plastic Surgeon
5.0 out of 5 stars 3 reviews

Botox and Results

Botox injected into the chin will not affect muscles of the neck. Botox will usually take 2-4 months to resolve, so you should be seeing some improvement.  I suggest you see an expert for future treatments. Best, Dr. Emer

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.9 out of 5 stars 159 reviews

Botox and Neck Muscles

You should soon see the Botox wearing off.  In some areas Botox can last a bit longer and you should return to your pre-treatment results.  Please consult an expert for this advanced injector technique.  Best, Dr. Green

Chin Botox complication

Sorry to hear about your experience with Botox injection to the chin. Yes, Botox injection to the chin can result in an asymmetric smile if the Botox in injected or diffuses into the DAO muscle which is right next to the mentalis muscle (the intended target of a chin Botox injection). The effects should wear off just like Botox wears off everywhere else. The time frame is usually 3-4 months but will probably be sooner as long as the physician didn't directly inject a full dose into the DAO muscle. If you can't wait for the Botox to wear off, the physician can inject the other DAO muscle to return some symmetry to you smile.  

In your case, it has already been 4 months so I suspect the Botox should be starting to wear off or will shortly. I would just wait. As for the two cords sticking out on your neck, those sound to be like platysmal bands which are not caused by Botox but are usually treated by Botox (usually 10-15 units into each band). Bands maybe caused by procedures that remove submental fat like Kybella or liposuction or even Ultherapy in some cases but Botox will not cause them. 

I encourage you to visit the person who injected you and let him/her know of your issues. I am also free to answer any other questions you may have. 

-Dr. Patel

When I smile my neck muscles are prominent, is this due to the botox?

Hello and thank you for your question!

Normally Botox lasts around 6-8 months, or in some cases it lasts a little bit longer depending on the concentration that was used. What you need to understand is that it is not a permanent treatment so it will go back to how it previously was prior to the application. In some cases we can use some medication that will accelerate the process.

Please consult a board certified plastic surgeon for further advice and the best, safest results.

Good luck!

Enriquillo Clime Rivera, MD
Dominican Republic Plastic Surgeon
5.0 out of 5 stars 3 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.