6 months after Botox, cheek still droopy. Should I see a neurologist?

Question

Had Botox by facial plastic 1/25. Couldn't smile for 2-3 months. Cheeks tight, shelving on cheeks, cheek bone area flat, smile not lifting, def. Not as tight now but still droopy cheeks. Been 6 months. Two in person second opinion said zygomaticus weakened. When I smile cheeks are lower on face and like round balls. See pictures. Shelving is still there but lips turning up now. Is the muscle too weakened to lift past the "shelf". They are like indents. Should I see a neurologist?

Anna Chacon, MD, FAAD · Answer

I'm sorry to hear about the issues you're experiencing. Given the persistence of your symptoms six months after receiving Botox, it is reasonable to consider further evaluation. Here are some steps you might take:

1. **Consult with a Neurologist:** Since the problem has persisted for an extended period and involves muscle weakness, seeing a neurologist could be beneficial. They can assess whether there is any underlying neurological condition contributing to your symptoms.

2. **Follow-up with Your Facial Plastic Surgeon:** It would be helpful to revisit the facial plastic surgeon who administered the Botox. They can provide insight into whether the effects you're experiencing are typical or if there might have been an adverse reaction.

3. **Consider a Specialist in Facial Nerve Disorders:** If available, a specialist in facial nerve disorders could provide a more targeted evaluation, especially if your symptoms are related to nerve or muscle function.

4. **Physical Therapy:** Sometimes, physical therapy or facial exercises can help improve muscle function and symmetry. A specialist can guide you on specific exercises that might help strengthen the affected muscles.

5. **Document Symptoms:** Continue to take detailed notes and photographs of your symptoms and any changes over time. This documentation can be useful for any healthcare providers you consult.

6. **Second Opinions:** If you haven't already, seeking additional opinions from other qualified facial plastic surgeons or dermatologists who specialize in Botox treatments can provide more perspectives on your situation.

It's important to address these concerns promptly to avoid any long-term complications. Make sure to bring all relevant medical records, photographs, and notes to your appointments to give the healthcare providers a comprehensive understanding of your situation.

Camille Cash, MD · Answer

I'm sorry to hear of the issues you have had since your Botox treatment.  You certainly can visit with a neurologist for an evaluation of your concerns.  It may be helpful to bring along your records from the Botox treatment to provide more specifics.  Before/After photos taken by your Botox provider may be helpful as well.

6 months after Botox, cheek still droopy. Should I see a neurologist?

Answers (2)

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