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Botox to Fix Crooked Smile Goes Wrong
While you may be able to get good symmetry with Botox injection on the other side the real problem is the staggering of the treatments. Botox works by blocking acetylcholine release, causing a chemical denervation. Meaning that the muscle is paralyzed. Over time (4-6 months) that paralysis wears off. If you get an injection now to balance out an injection you received a month previous you will likely have a period of symmetry followed by imbalance as the initial injection wears off. You should wait for all the Botox to wear off.
Clinical Context
Asymmetry after Botox can have more than one cause. Sometimes the muscles that pull down the corners of the mouth were already slightly uneven before treatment, and the injection just made this more visible. In other cases, the product spread beyond the intended muscle. If your asymmetry appeared right after injection and hasn't changed since, ask your injector whether pre-existing anatomy or placement, not timing, may be involved.
