My smile has completely changed after Botox on forehead, frown lines, crows feet, & under eyes. Any suggestions?

Dr. Dean Kane Q & A.

Q.  My top lip doesn't lift enough. When smiling with lips together it looks normal but when smiling or laughing with lips apart my top lip isn't lifting so looks like half a smile. My injectant didn't inject low down on crows feet but could it still have an effect on my smile muscles?

A.  Botox is a miraculous drug when used correctly. It is extremely artful and injector dependent on his or her skills.

Thank you for sharing your photos. When Botox or any of the muscle relaxer injectibles is not specifically targeted, adjacent muscles may be affected causing relaxation and therefore an imbalance on facial appearance. It appears that the muscles of your eyelids, your right lower lip and your cheeks received a dose of Botox during your injection session causing your eyelids and upper lip to drop and your right lower lip to raise.

The good news is that if minor amounts of Botox reached these muscles, the waiting time for the muscles to return to normal function is shorter than the average 3 months. It will also return to full function.

You may consider discussing the eyelid droop with an ophthalmologist as there is a eye drop than can help if seeing is a problem. You may also consider widening the area of placing your lipstick to camouflage the reduction in lip opening.

If you have concerns with your injector, consider another opinion by a well experienced, Board Certified Plastic Surgeon or ENT Facial Surgery injector to review these problems.

I wish you the best!