Botulinum toxin reduces activity in muscles. Around the mouth and lower face, very small muscles work together to produce smiling, lip closure, speech, drinking and expression. If one muscle is weakened more than intended, balance can temporarily change.
Patients may notice a crooked smile, one side moving differently, difficulty smiling fully, difficulty using a straw, changes when drinking, changes in pronunciation, lip weakness or a lip flip that feels too strong.
Lower-face Botox may affect function as well as appearance. Treatment around lips, mouth, chin, DAO muscles, gummy-smile muscles, jaw and neck requires conservative dosing and careful anatomy.
A lip flip uses small doses of botulinum toxin around the upper lip to reduce selected fibres of orbicularis oris. The aim is usually to allow the upper lip to roll slightly outward. It does not add filler volume.
Possible concerns include difficulty using a straw, difficulty pursing lips, dribbling when drinking, pronunciation changes, reduced lip closure, an unusual smile, asymmetry, excessive eversion or insufficient effect.
Yes. Gummy-smile treatment targets muscles involved in elevating the upper lip. If the muscular effect differs between sides, the smile may become asymmetrical or less animated.
Yes. The depressor anguli oris and mentalis are close to other lower-face muscles. Inaccurate or excessive treatment may alter smile symmetry or lower-lip movement.
Sometimes, but this must be approached cautiously. Weakening the stronger side to match the weaker side can worsen function. Sometimes the safer choice is to allow recovery.
Sudden facial weakness with arm or leg weakness, difficulty speaking, confusion, severe sudden headache, loss of coordination, vision problems or other acute neurological symptoms requires emergency medical care. Do not assume it is just Botox.
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