Question
I am 50. Last weekend (12/4) I had restaylene injected into the deep smile lines around my mouth. The plastic surgeon stated that if he put a touch of botox at the "dimple site" in my left cheek then it would soften the dimple and help to keep the restaylene in place and from seperating. (I had a deep line where my dimple was...so deep that it looked like a scar). I was thrilled with the results of the filler...you could barely see the line. But exactly a week later, the next Saturday at dinner time, the botox kicked in. I am devastated. My smile is uneven. I look like I am snarling when I smile. I am sick about this. I am a very animated person known for my smiley nature and I have to try to not smile at all. I saw my physician on Monday morning and he states that since it was injected into a very large muscle, and since it took a week to kick in, that it will last only a few weeks and not three months. Everything I read states that it will last 3 months. I have recieved botox in my crows feet at least 6 times and it lasts exactly three months. I am a nurse and went to work for the first time yesterday. I tried not to smile much and a co-worker who I confided in told me today that people are talking, wanting to know what is wrong with me. The left corner of my mouth doesn't raise up like the other side. My physicians's response was "I'm very sorry, but it isn't permanent and sometimes it grabs onto an opposing muscle.' So I am supposed to just live like this, try not to "grin" and just bare it? Might it actually not last a full 3 months? Thanks in advance for any feedback
Susan

Answer
I am 50. Last weekend (12/4) I had restaylene injected into the deep smile lines around my mouth. The plastic surgeon stated that if he put a touch of botox at the "dimple site" in my left cheek then it would soften the dimple and help to keep the restaylene in place and from seperating. (I had a deep line where my dimple was...so deep that it looked like a scar). I was thrilled with the results of the filler...you could barely see the line. But exactly a week later, the next Saturday at dinner time, the botox kicked in. I am devastated. My smile is uneven. I look like I am snarling when I smile. I am sick about this. I am a very animated person known for my smiley nature and I have to try to not smile at all. I saw my physician on Monday morning and he states that since it was injected into a very large muscle, and since it took a week to kick in, that it will last only a few weeks and not three months. Everything I read states that it will last 3 months. I have recieved botox in my crows feet at least 6 times and it lasts exactly three months. I am a nurse and went to work for the first time yesterday. I tried not to smile much and a co-worker who I confided in told me today that people are talking, wanting to know what is wrong with me. The left corner of my mouth doesn't raise up like the other side. My physicians's response was "I'm very sorry, but it isn't permanent and sometimes it grabs onto an opposing muscle.' So I am supposed to just live like this, try not to "grin" and just bare it? Might it actually not last a full 3 months? Thanks in advance for any feedback
Susan

Answer
Hi Susan
I definitely know how you are feeling. It is exactly a week tonight that my botox kicked in and my eyelid drooped drastically. I have done a lot of research and your doctor may be right... your problem may not last the entire 3 months since it took a week before it kicked in. I have learned over the last week that I have accepted the fact it will take time for this wear off. It was tough going to work but now I have adjusted.
It will get better, and even if your face doesn't return to normal immediately, you will feel better about it as the days pass until the one day you are back to your normal smiley self.
Good luck. Just know that there are many others out there going through the same thing.
I have tried everything from the acetylcholine drops etc... nothing has helped so far, but a freind recommended taking muscle relaxers at night and the botox may wear off more quickly. It's just a thought but I am going to try it and see that happens. I will let you know.

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Thanks so much for your reply!
I got a second opinion today from a woman who has done my crows feet with botox in the past. The man who used botox on my cheek is within her practice and very highly regarded.
She told me that it really will not last more than a few weeks tops due to it taking so long to kick in...says day 10 after injection is when it is at it's peak (which is today for me) and that every day it will lessen. Hopefully by the first of the year I will have the worst of it behind me.
I can fake it if I try to not be too animated and act super professional at work. I have driven myself crazy over it and have decided that if anyone is stupid enough to ask me what is up then I will in some way tell them it's none of their business. Like if they say "can I ask you a personal question?" I will say NO.
I am not that familiar with the eye syndrome, but do understand that nothing will make the botox go away other than time. It depends on how much you were given. My female doc prefers to give someone a small amount once then more a week later just in case they have eye droop...so it won't last too long. I am certain that it won't last the full 3 months. I am sorry that you are dealing with that.
I wish you well and please drop me a note when it is gone. It will just be a glitch in our past before we know it. It isn't permanent. This too shall pass.
Susan

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Hi Susan-
Thanks for the reply and nice words. I hope you are right and it will wear off in weeks rather than months. Mine kicked in pretty quickly so it's disturbing to think I will deal with this for months. But, I will definitely let you know when it starts to get better. Good luck to you. Stay in touch and let me know how you are doing.
Sloan

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Susan, having had the experience with eyebrows and lids and having read what must be several hundred posts over the past two years, I can confidently state that no one knows how long it will take. There is a range with people depending on the variables: how strong was the botox, how much was injected, where, how does the patient respond, etc. There is just no way to predict.
From what I've read, it's very rare for botox to wear off faster than three months, and it is often four or five months. Given your injection site, I can only suggest that you exercise those smile muscles as often as you can, but likely when no one can see you. I don't know if that will really help, but it might, and it can't hurt.
Otherwise, you have to wait like everyone else who has had this temporary disfigurement. It is temporary. It's just disheartening while it's going on. You will be back to normal, but it could be a few months.
Good luck, and speedy recovery,
J

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Hi J,
A question for you- I have major eyelid droop. And, I am concerned that the muscle that was accidentally injected will atrophy and never be the same, especially since it is a eyelid muscle that needs to work constantly while awake. Do you know anything about the effects of atrophy for muscles that have not been used once the botox wears off? Any info is appreciated. I just hope at some point my eyelid muscle works the same as it did before.. and eyelid droop will not be a life-time problem that I will need to deal with or surgically fix.
Thanks,
Sloan
PS This has definitely made me appreciate what God has given me. People were stunned at work that I would ever have botox. I am 35 and already look very young for my age.. so people have given me a very hard time for even doing it in the first place. Unfortunately, I have learned they are right.. appreciate what you have!!

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Hi Sloan
I have had really bad botox effects (you can read about my experience from the various posts). J can also testify that I was very badly traumatised (he has been encouraging me for the past one year)!
My eye brows and lids drooped so much that I had difficulty opening my eyes when I woke up in the mornings. My forehead was so frozen that I could not move it at all, and that affected my facial movements altogether. Because a lot of botox was injected all around my eyes too, my smile was badly affected as my upper cheek muscles were all immovable. It was very scary and was a bad nightmare!
I took about 5 - 6 months to see some improvement. After that, improvement was slow but evident. I was slowly, slowly getting better, moving more and more muscles. It has been almost 12 months now, and I can vouch that botox is temporary. Really. I had a lot of botox injected all over and the effects were really bad, but now, I am much, much better
I was only 28 when I went for the botox last year! There was barely any line or crow's feet on my face but the pastic doctor persuaded me to try botox saying that it is good for me - anti-ageing and a good preventive measure When the bad effects took place, I felt many more times guilty and ashamed than you. I blamed myself for being so vain and gullible. In fact, because I was rather 'disfigured' during that 'dark period', I went into a depression (compounded by another health prob).
I am so glad that 2005 is coming to an end. Last year, when the eyelid droop occurred, it was, coincidentally, 26 Dec (the day the tsunamis struck Asia). It was all so bad....
It's my prayer that 2006 will be a better year.
Sloan, don't feel bad....what's done is done...you cannot undo it. Learn from it and God will see you through it. I really got it very bad but I am so much better now, so take heart, botox is really temporary.
Ballerina

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Hi Ballerina,
Thanks for your words of encouragement. 5-6 months seems a very long time. I had hoped this would go away in a few weeks, which I have come to terms with, but months seems very depressing.
I'm glad to hear you are doing much better. I have read your other posts and can't believe the doctor pushed you into trying Botox, especially so much for your age. He needs to be sued because I am sure he is doing the same thing other people.
Thanks again and good luck to you,
Sloan

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Sloan,
Ballerina had the worst disfigurement case I've heard of, and she continues to make progress. Your muscles are genetically programmed to be and look a certain way--the way you are accustomed to. The botox effect is temporary, but always scary because we imagine it could become permanent. It won't. The muscles, even if mildly atrophied will return to normal. I do think it's useful to try to exercise them, however. Even a small movement will stimulate them and help reverse the atrophy. But, it almost always takes longer than you think and hope it will.
J

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Sloan,
Ballerina had the worst disfigurement case I've heard of, and she continues to make progress. Your muscles are genetically programmed to be and look a certain way--the way you are accustomed to. The botox effect is temporary, but always scary because we imagine it could become permanent. It won't. The muscles, even if mildly atrophied will return to normal. I do think it's useful to try to exercise them, however. Even a small movement will stimulate them and help reverse the atrophy. But, it almost always takes longer than you think and hope it will.
J

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Hi J,
Thank you for the reply. It's very encouraging to hear my eye will return to normal eventually. I would hate to have a droopy eyelid for the rest of my life.
Unfortunately, my brother's wedding is in exactly 3 weeks and I am a bridesmaid in the wedding. I can't decide what to do... pull out now so they can get a replacement or hope that my eye will be good enough to be in pictures. It is getting slightly better, but it is still very noticeable. So, I'm not sure what I will look like in 3 weeks... at that time it will have been 5 weeks since the botox injection. A decision I must make soon in order to give them time to replace me, but I sure as heck don't want to have a picture reminder of this for the rest of my life (plus ruin the photos for my brother/his new wife either). They are very supportive and have told me it is completely up to me.
Also, I have learned how to "McGiver" my eye (for those of you outside the US, it was a tv show about a guy who could use everyday materials to fix/ get out of bad situations).
Basically, I use a piece of the sticky part of clear bandaids to tape my eyelid up. Then, I wear eyeglasses to mask it somewhat. It is still noticeable if you get close enough to talk me, but at least I don't look like half of my face is on heavy sedatives.
I decided that I had to get creative and that was my short-term solution to the problem. If I wear a baseball cap too, you don't notice it at all. However, I can't wear a baseball cap to work, so I have to deal with everyone at work knowing what happened.
Oh well, life goes on. I wrote all of the above in case it helps someone else out with the drooopy eyelid problem who finds this site.
Thanks again for the replies to my question to both J and Ballerina. You both are a godsend to others who will no doubt experience the same problem.
Sloan

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Hi Susan-
Is your face/cheek getting any better?
Sloan

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Wow, I have not received notification by e-mail of new replies and thought there were none, but here I am with a very supportive list! Thanks to everyone participating, I really appreciate this.
Tomorrow I go for a follow-up to check out the progress. I will find out the "actual amount" injected. J, they are adamant that a small amount in the major muscles of the cheek will not last very long as compared to the crows feet of the eye. I do have to say that it does seem to have eased up a bit but by my standards, is still so very much there. I have lost my "trademark" smile and am sick over it but am telling myself that it will pass. Went to a couple of Christmas parties this weekend and have never felt so self concious in all of my life. Man I hate this. Here is a little more personal history...I am 18 months into a divorce, have to give up meeting new people (my smile looks snarly!) I have good genes, am in great shape, and I am flipped out over what I have self-imposed on myself. I took it all so for granted and I want it back! Should I start a post to never let anyone inject botox in the lower face? Thanks for all of your support.
Susan

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I agree Susan!!! As they say, you don't what you've got til it's gone. Glad to hear you are slightly better. I went to my dermatologist today and he said my eye should be back to normal by my brother's wedding which is now 2 1/2 weeks away. I can deal with it until then as long as I continue to see minor improvements. My eyelid is probably 50% where it should be which is an improvement over a couple weeks ago when it was about 20% open. It definitely makes you appreciate your health and your looks.
Stay in touch. Hope you continue to get better. Just think about all the self-confidence you will have as you meet new people when your smile returns to normal. It's funny I have been going through a break up as well... maybe it's God's way of saying love yourself as you are.. Just a thought.

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Sloan and Susan,
You both describe what most everyone feels after doing this to themselves. It's a great learning opportunity that might prevent you from doing something more foolish and more permanent in the future.
I have heard of people with severe eyelid droop recovering quickly. When that happens, I think it is because of a botox drift into surrounding tissue that affects the lid, rather than a direct injection into the affected tissue and muscles.
And, we can only hope that the recoveries go faster for both of you. Remember also for the wedding, that you can try to get more distant shots than close ups of yourself. My personal opinion is that you should be there in all your glory and just take this mistake in stride. You may regret not being a part of the wedding later more than not looking your best.
Good luck to both of you,
J