Botox/Dysport in the lower face…chin, upper lip, jawline.

Hello doctor, i did botox on my chin twice to correct cobblestones ; once it barely did nothing , the other i was left without being able to smile properly for three months (could not pull down my lower lip). Is it really difficult to get the chin right? I am a little scared to go for it again (it was with two separate doctors). Thank you so much

What are the ‘opportunities’ in the lower face, and what are the possible problems.?  What you went through sound frustrating, especially when your smile goes a little wonky for 3 months. The only good thing here on timing might be the Covid mask covers it.

The upper lip

  • Why?  Softens and helps prevent progression of upper lip lines.  Can be used for lower ones as well?
  • What can go wrong?  Must be done carefully and lightly.  Too much causes the upper lip to droop, and an inability to purse the lip, drink and even eat without drooling.

The chin

  • Why?  Reduces and prevents that ‘orange peel’ look.  The French call it peau d’orange.
  • What can go wrong?  Too much can diffuse and catch fibers of neighboring muscles that control the lower lip (the problem you had). Too little and nothing changes.   Fix is to use enough but keep it more central.  Botox is better than Dysport in this location because it diffuses less.

The ‘Marionette’ lines

  • Why?  Helps to to soften or eliminate the crease from the corner of the mouth to the chin.  Often filler may be needed to accomplish this also.
  • What can go wrong?  Same as above, just a few millimeters off and the smile can be affected.  Even when correct the lower lip may have an odd shape with certain expressions.

The jawline

  • Why?  Sometimes called the ‘Nefertiti’ lift, the muscles of the platysmal bands which insert on the jawbone (mandible) relax and create a more youthful jawline.
  • What can go wrong?  Too much can unbalance the muscles around the neck and cause a feeling of instability of the head in certain positions.  Too little and there is no change.

As with everything (almost) in life, there really is no one-size-fits-all to the above.  Work really needs to be customized for you!

Hope this helps,

Dr. B

Dr. Brandith Irwin, MD

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