Side effects - Botox gave me a crooked smile. What should I do?

Suzanne,

Botox works by paralyzing muscles. This effect is beneficial in the forehead and around the eyes (crow's feet area) to reduce wrinkles caused by dynamic muscles. The muscles in your cheeks and around your mouth have very important functions in chewing and talking. While it is tempting to inject Botox in the upper lip and jowel area, it really serves no purpose. Most of the wrinkles in lip and around the mouth are static - that is, they are present even when the muscle is not contracting. These wrinkles require resurfacing to smooth them out or fillers from below to fill the defect. Now that you have had Botox injected around the mouth and you are suffering the dreaded temporary complication, the only way to help is to try and restore the balance of the muscles. This may be helped by injecting Botox on the other side to help restore symmetry or in an opposing muscle. In any case, you should talk about all of these issues with your doctor and make sure that only experienced people are injecting your Botox.

I hope this was helpful.

David Shafer, MD
Shafer Plastic Surgery
New York City

Greetings Suzanne,

I would definitely agree with Dr. Persky on all points. You may be able to have the opposite side injected to even out the smile. In the alternative take heart - this will resolve on its own and you should notice some motion in probably a month or two.

Hi Suzanne,

I would return to the physician who treated you.  After examining your peri-oral muscles and their movement, it would be possible to determine whether a small additional Botox would "even out" your smile.  I'm sorry that you are having problems, but this again emphasizes the importance of having an experienced physician with knowledge of the underlying muscles performing Botox injections.  This is a medical procedure.  Be well and hopefully a quick recovery of your beautiful smile.

Dr. P