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Asymmetric Smile after Botox


Have you ever had an asymmetric, crooked, or uneven smile after a Botox treatment? This is a rare side effect. Keep reading to learn more.

What is Botox?

Botox is a purified protein used to treat wrinkles caused by facial expression. Botox works by relaxing muscles, which smoothens out your wrinkles.

Where can Botox be used?

Botox can be used on many areas. Botox is best known for treating frown lines between your eyebrows, horizontal forehead wrinkles, and crow’s feet around your eyes. But Botox can also be used for a gummy smile, lip flip, lifting the corners of your mouth, chin wrinkles, and slimming your lower face.

How can you get an asymmetric smile after Botox?

Botox works by relaxing muscles you use to make facial expressions. One facial expression you don’t want to have affected is your smile. You have many muscles around your mouth that you use to smile. The zygomatic major and minor muscles pull the corners of your mouth up and out. The LLSAN (levator labii superioris aleque nasii) muscle pulls you upper lip upward. The risorius muscle pulls the corners of your mouth our towards your ears. And the depressor labii inferioris (DLI) muscle pulls down your lower lip, and you have one of these muscles on each side. When Botox spreads to any of these muscles, it will relax them. Usually this only happens on one side. This makes your smile on that side look different.

When treating your crow’s feet, if the lowest Botox injection is placed too deep, it can affect the zygomaticus muscles. This will make it hard to lift and pull out the corner of your mouth on the affected side. If the Botox spreads when treating your bunny lines or when doing a lip flip, it can spread to the LLSAN muscle. When this happens, you have trouble lifting your upper lip on that side. Botox can be placed in the masseter muscle (the primary muscle you use to chew) to relax it and slim the lower face. If the Botox is placed too superficial or too close to the mouth, it can spread and affect the risorius muscle. This will make it harder to pull the corner of your mouth out toward your ear on the affected side. Botox can also be placed in a muscle called the DAO (depressor anguli oris), which pulls down the corners of your mouth. This will lift the corners of your mouth and decrease a sad face appearance. If it spreads from this muscle, or from the mentalis muscle targeted for chin wrinkles, it can affect the DLI muscle. This will make it harder to pull down your lower lip on the affected side.

Obviously having an abnormal smile is not desirable. Some people say it looks like you’ve had a stroke. Therefore, it’s important to have your Botox treatment by an injector with experience to avoid this side effect and other side effects such as droopy eyelids or blurred vision. Also, after your Botox treatment be sure to avoid heat exposure, alcohol consumption, and strenuous exercise for 24 hours after your Botox treatment. And avoid bending forward or lying flat by staying upright for four hours after your Botox treatment. Doing any of these things can increase the likelihood of spreading the Botox to other muscles, which causes side effects.

How long does an asymmetric smile after Botox last?

Fortunately, the effects of Botox are temporary, including side effects such as an asymmetric, crooked, or uneven smile. Most people enjoy the intended effects of Botox for three to four months. This is when the Botox is placed directly into the muscle it is intended to relax. When the Botox spreads to nearby muscles, usually only a little bit of the Botox spreads. So the side effects normally don’t last the full three to four months. Side effects such as an asymmetric smile usually go away on their own within two to four weeks.

How can I treat my asymmetric smile?

Although side effects such as an asymmetric smile usually go away on their own, you can speed it up with infrared lasers or radiofrequency. Dr. Alex can perform a laser skin tightening treatment on the area. This uses gently micro-pulses of infrared light to slowly and gently heat the skin. This brings blood flow to the area and stimulates the muscles. This can be done multiple times if necessary.

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Dr. Alex has performed over 10,000 cosmetic treatments with many satisfied patients. Contact us to schedule an appointment for a free consultation with Dr. Alex in our Encino, CA office.

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