Plastic Surgeon Dr. Dean Kane of Baltimore Answers Question Regarding Botox Onset and Duration, Muscle Variation

Q. Does Botox effect vary in different areas? Can botox wear off faster from around the lips than forehead? I had one unit of botox last week under my lip and my upper and lower lips are numb now. I hardly can talk and I can not smile at all. The Doctor says RF and heat helps.

A. Thanks for your interesting observation. 

I have found Botox and Dysport return-of-function consistently different in various facial muscle groups. I have divided these muscle groups into:

  1. Muscles of expression, and 
  2. Muscles of protection. 

The muscles of expression include the 3 glabella muscles: corregator supercillii, procerus and depressor supercillii and platysma bands. These injectable muscle relaxants last longest in these muscles as I believe there is less central stimulus to generate axonal budding and therefore longer return-of-function and more muscle atrophy. 

Muscles of protection such as the orbicularis oculi and oris ring muscles close the eyes and mouth, have much more activity and must recruit other muscles to protect these organs rather than generate expression. The return-of-function is much quicker and muscle hypertrophy or thickening of the muscle group can continue. I observe there is faster return-of-function when massage, exercise and TENS stimulation is used. 

Your finding, I believe is to be expected. Botox tends to act 5-7 days following injection with a peak at 10-14 days. In the case of the ring muscle around the mouth, I suspect you will find that the 2nd and 3rd layer of muscle will recruit and you will have the desired weakness along the lip vermillion with a out-pouting of the lip white roll but complete closure and function of your mouth and lips. 

Always consult with a skilled and talented, Board Certified Plastic Surgeon. Botox injection is a advanced technique to achieve rebalance of the facial muscles. I wish you the best. 

Read more about similar topics:

Botox Failure

This information is not meant as medical advice. It is provided solely for education. Our practice would be pleased to discuss your unique circumstances and needs as they relate to these topics.

Give us a call at  410.602.3322  or email Lauri@DrDeanKane.com and make an appointment soon. We’re located on Reservoir Circle just a block off the Baltimore beltway, convenient to greater Baltimore, Annapolis, the Eastern Shore, Southern Pennsylvania, Delaware and Carroll County.

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