Botox for bunny lines not going away after 8 months. Could I potentially have nerve damage? (Photo)

Question

I hope someone can help me. I got botox for bunny lines 2-3 units on each side. Very minimal. Everything was fine but two weeks later my smile started to droop. That was 8 months ago and my smile is still crooked with no signs of improvement. Could I potentially have nerve damage? Also, when using a microcurrent device, that side of my face is not as reactive as the other side. Thank you for your time.

James M. Economides, MD, FACS · Answer

I understand how frustrating and worrying this must be for you, especially given that it's been 8 months with little improvement. While Botox is generally temporary, the situation you're describing could potentially have a few different causes:

1. Prolonged Botox Effect:
While rare, Botox effects can sometimes last longer than the usual 3-6 months, particularly if there was over-injection or if your body metabolizes Botox more slowly. However, the dosage you received was quite minimal, so this prolonged effect could be unusual.
2. Nerve Damage:
Botox doesn’t typically cause permanent nerve damage, but if the injection inadvertently affected a nearby nerve, it could result in temporary weakness or asymmetry. Given that you mention a microcurrent device showing less reactivity on one side, it could indicate some nerve involvement, though true nerve damage from Botox is rare.
3. Muscle Weakness:
The drooping smile may be due to unintended muscle weakening from the Botox, affecting muscles that control your smile. If those muscles have been inactive for a while, they could become weaker and need more time to regain their function. In some cases, muscle retraining (through facial exercises or therapy) might help restore balance.
4. Next Steps:
Consult with a Specialist: It's important to seek advice from a board-certified dermatologist or plastic surgeon who specializes in Botox complications. They can assess whether there’s a need for treatment or intervention to address any potential nerve or muscle issues.

Camille Cash, MD · Answer

I'm sorry to hear of the concerns you have had from your Botox treatment.  The effects on the muscle from Botox are temporary, typically lasting three to four months.  As your injections were over eight months ago and your issue has not resolved I encourage you to visit with your injector for an evaluation.  Permanent nerve damage would be rare.

Anna Chacon, MD, FAAD · Answer

I'm sorry to hear about the issues you're experiencing. Here are a few points to consider regarding your situation:

1. **Botox Duration and Effects**: Botox typically lasts between 3 to 6 months. If the effects on your smile and muscle function have persisted for 8 months, it suggests that something unusual might be happening.

2. **Nerve Damage**: While Botox can affect nerve function temporarily by blocking the neurotransmitters that cause muscle contraction, it is less common for it to cause permanent nerve damage. However, the persistence of symptoms beyond the usual duration warrants further investigation.

3. **Crooked Smile and Muscle Reactivity**: The fact that your smile is still crooked and the affected side of your face is less reactive to a microcurrent device suggests that there might be an underlying issue that needs to be addressed. This could potentially be related to nerve irritation or other complications.

4. **Consultation with a Specialist**: It is essential to consult with a healthcare professional, preferably a neurologist or a specialist in facial nerve function, to evaluate your symptoms. They can perform a thorough examination and possibly recommend diagnostic tests such as nerve conduction studies or electromyography (EMG) to assess nerve function.

5. **Follow-Up with the Injector**: If you haven't already, it would be prudent to follow up with the practitioner who administered the Botox. They can provide insight into what might have gone wrong and guide you on the next steps.

6. **Possible Treatments**: Depending on the findings, treatments may vary. Physical therapy, neuromuscular retraining, or other interventions might be recommended to help restore normal function.

Given the persistence of your symptoms and the potential for nerve involvement, seeking a professional evaluation as soon as possible is crucial for appropriate diagnosis and management.

Botox for bunny lines not going away after 8 months. Could I potentially have nerve damage? (Photo)

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Botox for bunny lines not going away after 8 months. Could I potentially have nerve damage? (Photo)

Answers (3)

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Everything you need to know about Botox

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