A woman who got Botox to even out her smile says the injection 'spread' across her face and now she has a lisp

• TikTok user Nikita Kimberly said her Botox procedure left her with uneven lips and a lisp.
• Dermatologist Marisa Garshick said lower face muscles are small and close together, which can lead to Botox problems.

TikTok user Nikita Kimberly dealt with a self-described "Botox fail" last year, and she's posting about her experience so other young people know the risks.

Kimberly said she received Botox in September 2021 to lessen the appearance of a dent on her chin when she smiled.

About three days later, Kimberly told Insider, she noticed her "face turned crooked" as the Botox had migrated to a muscle that it was not intended for, moving from her chin toward the left side of her mouth. She says she looked in the mirror to find an uneven smile and a lisp.

Kimberly said her doctor told her she could correct the lopsided effect by getting more Botox on the other side of her mouth, but she told Insider she decided not to. She doesn't want the procedure again; she is waiting until the effects wear off in a few months.

"Don't get Botox, please," she told her 3,000 TikTok followers. "Lip filler is fine, but don't get Botox."

Kimberly is among millions of people who received Botox, a toxin designed to relax muscle movement, during the COVID-19 pandemic. The American Society of Plastic Surgeons found Botox became the most popular non-invasive cosmetic procedure in 2020, which some plastic surgeons credit to people spending more time staring at themselves during Zoom meetings.

Why Botox injections around the chin and mouth require precision from a professional

Getting Botox on lower face muscles poses a greater risk that the toxin will migrate or get injected to the wrong place because the muscles in the area are small and close together, according to Dr. Marisa K. Garshick, a board-certified dermatologist based in New York City.

"Even though the original injection was targeted at the correct muscle, there is some movement that can occur and cause it to effect one muscle on one side over the other," Garshick told Insider.

Over time, the effects of Botox settle, and unevenness generally fades within two to three months, Garshick said. But the best way to prevent a botched Botox is to avoid massaging the face and intensive exercise anywhere between 24 hours to two weeks after the procedure, Garshick added.

How to pick a cosmetic surgeon for your Botox treatment

The most important step to prevent Botox mishaps is to make sure your procedure is done by a board-certified plastic surgeon or dermatologist, said Dr. Debra Jaliman, a board-certified cosmetic dermatologist in New York City. Unqualified practitioners may not be adequately trained on facial anatomy, increasing the risk that they might inject into the wrong muscle.

Jaliman said patients can spot shady practitioner through highly discounted prices. Botox tends to cost around $400 to $500 per area treated. She also recommends asking the doctor for before and after photos of their own patients.

Jaliman described one patient who she says came into the clinic after receiving Botox at a discounted price and "had an infection in her face for eight months."

"I know people wanna save money, but I don't think your face and your health is where you should save money," Jaliman said.