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  5. A woman has an extreme crooked smile after getting Botox for her chronic pain — and the side effect will last months

A woman has an extreme crooked smile after getting Botox for her chronic pain — and the side effect will last months

Julia Pugachevsky   

A woman has an extreme crooked smile after getting Botox for her chronic pain — and the side effect will last months
Science3 min read
  • Brittany Ngo, 38, got Botox injections to alleviate chronic pain from a nerve condition.
  • After a few days, she developed a crooked smile that only got worse.

Brittany Ngo, 38, had never tried Botox before. But when her doctor suggested it as treatment for trigeminal neuralgia, a nerve condition that causes chronic facial pain, Ngo decided to try it.

Though Botox is known for reducing wrinkles, it can also be used to treat multiple medical conditions like migraines and teeth grinding.

Ngo, who normally experiences "really bad tooth pain" on the left side and top part of her jaw, received about a dozen Botox injections around that area.

But days later, she noticed the left side of her face starting to dip into a crooked smile. While she said the neurologist administering the Botox warned her of a "slight facial droop," the side effect kept getting worse.

Her smile got more crooked the week after her injections

Ngo said her smile became crooked four days after getting Botox, but "by day eight, it was really extreme."

She decided to ask the r/30PlusSkinCare Reddit community since she "figured a lot of people get Botox in there and they probably know the answer better than some other places I was looking."

The comments were full of concern. Some people worried she had a stroke or Bell's palsy, a form of facial paralysis. She decided to take Reddit's advice and see her neurologist again.

The side effect will wear off, but it'll take months

The neurologist confirmed that Ngo wasn't having a stroke or Bell's palsy, but that she was experiencing an extreme side effect of the Botox injections. Ngo was told it was likely caused by too high a dosage of Botox in that area.

The doctor encouraged her to take photos and videos for future sessions, so that the neurologist administering the treatment will know to dilute the Botox and stay away from that part of her face.

Until then, all Ngo can do is wait for the Botox to naturally wear off, which usually happens around the three-month mark, though it can take longer.

Ngo got the treatment on November 1, and said that over a month later, she hasn't seen any improvement in her smile.

Ngo isn't sure if she'll get Botox again

Ngo said she's adjusted to the feeling of her smile and hasn't had too many issues with eating. The biggest annoyance has been going out in public.

"When I look in the mirror, it looks crazy," Ngo said. "I did some PTA events and they all thought I had a stroke."

While her appearance hasn't stopped Ngo from living her life, she said one thing she'll have to miss is taking holiday photos with her family this year.

As for getting Botox again, Ngo said she's on the fence. She did feel a slight improvement in her facial pain, and was told she would start feeling better by her second or third session.

At the same time, she worries about going through this again.

"With neurologists, I think their number-one concern is pain," Ngo said. "I don't think they necessarily bring the cosmetic into focus when they're applying it." She's wondered about going to a cosmetic surgeon, but isn't sure how it would work with her insurance.

For now, she's sitting tight and laughing off the situation.

"I've always been kind of somebody who kind rolls with the punches," she said. "I started getting a little bit ill around two years ago neurologically, and since then, I just kind of take things day by day."


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