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Botox to treat gummy smile - first injection leaked into mouth.

I'm sorry to hear about this situation. Unfortunately, it's difficult to know what the outcome will be. If the first injection was truly injected intra-orally and none of it went into any muscles, they there won't be much effect from the first injection. However, if some of it went into the surrounding muscles, it's possible you may have some asymmetry at the 2 week mark. It's best to follow up with your injector at 2 weeks to re-evaluate. The good news is that the results from Botox are temporary and will resolve on its own.

Clinical Context

Botox for a gummy smile targets small muscles that lift the upper lip, which sit close to the inside of the mouth. If some of the injection missed muscle and went into the mucosa, that portion won't affect the smile. Over the next couple of weeks, watch for asymmetry between the two sides and confirm normal movements like pursing your lips or drinking through a straw still feel normal. Report any changes to your injector at your follow-up visit rather than waiting longer than needed.

Answered By

Dr. Steven Williams

President Emeritus of ASPS

Dr. Steven Williams is a board-certified plastic and reconstructive surgeon, a diplomate of the American Board of Plastic Surgery, the Past President of the prestigious American Society of Plastic Surgeons, and a charitable person who dedicates his life to those in need of his unique expertise.

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