Thank
you for your question.
You submitted several photos and you state that you underwent Botox® for the chin and
specifically, you had 4 units and it resulted in challenges for you in your ability to speak,
the way you smile and the position of your lower lips relative to your teeth.
So you are looking for some guidance on what to do moving forward.
Well, I can certainly give you an opinion as to what I believe is the situation.
A little bit of background, I’m a Board-certified cosmetic surgeon and Fellowship-trained oculofacial
plastic and reconstructive surgeon.
I’ve been in practice in Manhattan and Long Island for over 20 years and our specialty
was one of the first to use Botox® so I’ve been using Botox® for facial rejuvenation
since 1993.
Now, in terms of what was probably the intent of the placement of Botox® in the chin, I
suspect you were getting improvement of some chin dimpling.
There is a muscle called the mentalis muscle that is associated with this peau d'orange
or dimpling of the chin and so 4 units is a very small amount that is typically done
and usually, it limits the effect to that muscle.
A little bit in that same area, just a little bit deeper, the muscles that actually depress
the lip or bring the lip downward are also present and that’s why you can see in one
of your photos, one side of the lip coming down further than the other.
It appears the Botox® is affecting more than the intended target muscle and because of
that, you are getting this effect.
Now, the question that comes to mind is actually the number of units is relatively small.
It’s a little bit unusual from my experience to see that amount of effect.
If it turns out that this is the number of units then it just means that this material
diffuses very easily into the adjacent muscle.
Since Botox® effects are usually limited to 3-4 months given the number of units used,
there is a good chance that this effect will wear off in about a month to 6 weeks.
At least you will have a better appearance at that time.
Unfortunately, there is no way to reverse Botox®.
Sometimes, if someone has an undesirable result that causes an imbalance, you can do Botox®
to affect other muscles to kind of balance it out and create symmetry.
I’ve certainly done that for patients with issues with asymmetric upper lip or even lower
lip after either injectable treatment or the use of neuromodulator like Botox® done elsewhere
and we try to balance them out so that they can kind of allow them to coast through the
next few months and let everything wear off.
That being said, for now, I think it is probably better to just wait.
I don’t think that given the number of units, even if it’s slightly more, it should wear
off fast enough.
Like I said, there is nothing much else we can do in the meantime.
So, I understand that you speak for a living and at some adaptation will be necessary to
try to get past this but I think it’s just going to be a matter of time before you’re
back to your normal self and chances are, you may want to reconsider doing it in the
future given what this outcome was.
So I hope that was helpful, I wish you the best of luck and thank you for your question.