How to correct a crooked smile caused by Botulinum toxin (Botox)?

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From the Guidelines

To correct a crooked smile from Botox, you should consult with an experienced injector who can administer additional Botox to balance your facial muscles, as there is no direct evidence from the provided studies 1 that addresses this specific issue, but based on the general understanding of Botox's mechanism of action and its use in treating facial asymmetries. The procedure typically involves placing small amounts of Botox (2-4 units) in strategic locations on the stronger side of your face to weaken those muscles and create symmetry.

  • The procedure takes only a few minutes, with results visible within 3-7 days.
  • If your smile is severely asymmetrical, you may need to wait for the original Botox to wear off completely (3-4 months) before getting a completely new treatment with more precise placement.
  • During your appointment, the provider should take pre-treatment photos, carefully mark injection sites, and use the smallest effective dose to avoid overcorrection. Botox works by temporarily blocking nerve signals to muscles, so strategic placement can relax overactive muscles that are pulling your smile to one side.
  • Never massage or manipulate the treated area after correction, as this can spread the toxin to unintended muscles and worsen the asymmetry. It's worth noting that the provided studies 1 focus on the use of Botox for treating hoarseness (dysphonia) and do not directly address the correction of crooked smiles, but the principle of using Botox to relax overactive muscles can be applied to this condition as well.

From the Research

Correcting Crooked Smile from Botox

To correct a crooked smile caused by Botox, it is essential to understand the effects of botulinum toxin on facial muscles.

  • Botulinum toxin is a neurotoxin that blocks the release of acetylcholine, causing muscle paralysis 2.
  • The toxin is commonly used for cosmetological applications, including the correction of lines, creases, and wrinkling on the face, chin, neck, and chest 2.
  • However, incorrect use of botulinum toxins can lead to unwanted effects, such as a crooked smile.

Treatment Options

There are several treatment options available to correct a crooked smile caused by Botox:

  • Waiting for the effects of the toxin to wear off, which usually takes about three months 2.
  • Using additional botulinum toxin injections to balance out the facial muscles 3.
  • Considering alternative treatments, such as facial exercises or other cosmetic procedures.

Important Considerations

When seeking treatment to correct a crooked smile caused by Botox, it is crucial to:

  • Consult a qualified healthcare professional with experience in botulinum toxin therapy 4.
  • Discuss the potential risks and benefits of treatment, as well as any alternative options 5.
  • Follow the recommended treatment plan and attend any necessary follow-up appointments to ensure optimal results 6.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Botulinum toxin.

Indian journal of dermatology, 2010

Research

The Multispecialty Toxin: A Literature Review of Botulinum Toxin.

Plastic and reconstructive surgery. Global open, 2022

Research

Botulinum toxin: bioweapon & magic drug.

The Indian journal of medical research, 2010

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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