Smile crooked after masseter botox or lip filler? (Photo)

Question

Hi, I got masseter Botox of 25 units each side from an MD who also does plastic surgery, to slim my face. 1 week later, I got lip filler of .75 a syringe from a different injector. I started noticing my smile being crooked and my smile lines, as seen in the after photo. My smile lines were even before and I can only move one side to stretch my smile up. The other muscle can’t move my mouth or smile line that far. Was this from the masseter Botox or lip filler?

Camille Cash, MD · Answer

One way to determine which treatment is related to your concern is to observe your face at rest.  If it is even at rest but crooked when you smile it is likely from the Botox.  If it is crooked at rest and when smiling it is likely from the filler.  Either situation is temporary and will gradually improve.

Eric M. Joseph, MD · Answer

Based on your photo, it appears that you have difficulty elevating the corner of your mouth on the right side. This certainly could be from the masseteric Botox injections. This will completely wear off in 3 months, and you should notice Improvement in your smile 6 weeks after your procedure or sooner. I hope this helps. Sincerely, Dr Joseph

Philip S. Schoenfeld, MD, FACS · Answer

The photo that you have provided shows an asymmetry when you smile in the lower lip area.  It would be very unusual to inject Botox into the masseter muscle and result in lower lip weakness without having some of that neuromodulator injected into the depressor angularis oris.  Not entirely certain what is going on but it will wear off in a short period of time.  I would pose this question to your Botox injector.

Matthew Zeiderman, MD · Answer

Thanks for the question. This is more likely from the botox which has likely weakened some of the smiling muscles on the right of your face. Filler shouldn't weaken muscles.

Lexie Wang, MD · Answer

Hi! If the asymmetry is seen at rest, then it is related to the filler. If it is only visible with movement (like smiling), then it is probably related to the botox injection. I have commonly seen that botox injections of the masseter that either come too medially or too superiorly will impact the smile muscles as they start to interdigitate in these locations. The good news is that it will wear off!

Smile crooked after masseter botox or lip filler? (Photo)

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Answer: Botox

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Smile crooked after masseter botox or lip filler? (Photo)

Answers (6)

Answer: Botox

Answer: Botox

Answer: Mvmt

Answer: Mvmt

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Recommended reading

Everything you need to know about Botox

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