Last Updated on December 31, 2025 by Giorgia Guazzarotti
You went in for Botox and came out looking like you had a stroke, and now one side of your face won’t cooperate when you smile and honestly this is a nightmare you weren’t prepared for because nobody warned you this could happen. Welcome to the world of crooked smiles after Botox injections, and I’m here to tell you what went wrong, how to fix it, and how long you’re stuck with this mess because you deserve actual answers instead of reassurances that “it’ll be fine” when right now it very much does not feel fine.
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What Happens To Your Smile When Botox Goes Wrong
Your smile uses multiple facial muscles working together: the zygomaticus muscles lift your mouth corners, the levator labii superioris pulls up your upper lip, the risorius muscle pulls corners toward your ears, and the depressor labii inferioris pulls down your lower lip. When Botox hits the wrong muscle or spreads where it shouldn’t, the whole system falls apart and you get that asymmetrical smile that has people asking if you’re okay. Here’s probably what happened based on where you got injected:
- Crow’s feet treatment gone wrong: The injection was too low or too deep and hit your zygomaticus muscles, so now you can’t lift one corner of your mouth properly and your smile looks lopsided and weird.
- Lip flip or bunny lines: Botox spread to your LLSAN muscle and now your upper lip won’t lift on one side, which makes you look like half your face is frozen while the other half moves normally.
- Masseter botox for facial slimming: Super popular on TikTok but risky as hell because if the masseter injections are too shallow they affect your risorius muscle and suddenly the corner of your mouth won’t pull out the way it should when you smile.
- DAO treatment for downturned mouth: The botulinum toxin treatments spread from the depressor anguli oris to your depressor labii muscle and now your lower lip is asymmetrical when you talk or smile, which is extra frustrating because you got treatment to improve your smile and instead made it worse.
The reason it only affects one side is because Botox doesn’t travel far from where it’s injected, so you get this obvious uneven smile where one side works fine and the other is partially paralyzed.
What Causes A Crooked Smile With Botox
Your injector made a mistake, whether from inexperience or bad technique or just not understanding facial anatomy well enough to work around the mouth safely. The lower face isn’t beginner territory: the muscles of the lower face overlap and intertwine and there’s almost no margin for error, which is why good aesthetic practitioners don’t let newer injectors anywhere near this area.
If your provider didn’t watch you smile and animate your face before injecting, that’s a massive red flag because you can’t plan proper injection techniques without seeing how someone’s individual facial muscles actually move. If they were rushing or if you got a deal at a med spa running specials, that’s exactly the setup where smile asymmetry complications happen because the business model prioritizes volume over taking time to assess each patient properly.
Injection depth matters enormously too. Too shallow and Botox spreads across the surface hitting the wrong muscles. Too deep and it migrates to deeper layers affecting different movements entirely. The “correct” depth varies by muscle, location, and how much fat you have there, and a lot of injectors just don’t have enough training to judge this accurately every time.
How To Fix It
Treatment Option One: Do Nothing and Wait
This side effect of Botox are temporary, which means your crooked smile will eventually resolve on its own once the botulinum toxin injections wear off and your muscle function returns. When Botox spreads to muscles it wasn’t supposed to affect it usually wears off faster than when it’s properly placed. You’re looking at two to four weeks for minor asymmetry from spread, though it could take up to three or four months in some cases.
The good news is it will definitely go away. The bad news is walking around for weeks or months with an asymmetrical smile that affects how you eat, drink, talk, and show up in the world, and that’s a long time to deal with emotional stress and people constantly asking what’s wrong with your face. Choose this option if the asymmetry is mild or if you don’t trust anyone to make it better without potentially making it worse.
Treatment Option Two: Get Corrective Botox
You can get strategic botulinum toxin injections on the opposite side to balance things out and create symmetry, but here’s the catch nobody explains properly: you’re staggering treatments now, which creates a timing problem. Let’s say your bad injection was on the left side at day zero. By day ten your crooked smile appears. You get corrective treatment on the right side at day seventeen to balance it out. For weeks six through twelve you have beautiful symmetry because both sides are equally affected. But then around week thirteen the original left side starts wearing off while the right is still frozen, so now you have asymmetry again but reversed. By week twenty everything’s worn off and you’re back to normal.
This means you’ll likely need another correction when the first injection wears off to avoid that reversed asymmetry phase, and you’re essentially committing to managing this situation over several months rather than just waiting it out, but if you have important work events or you’re in a patient-facing role or this is seriously affecting your mental health then the corrective treatment might be your best option even with the timing complications.
If You Go The Correction Route
Do not go back to whoever messed this up unless they’re a highly reputable plastic surgeon or dermatologist who takes full responsibility and has a clear plan to fix it. Find someone board-certified with advanced training who specifically has experience with corrective treatments and who can explain exactly which muscle they think was affected and where they’ll inject to balance it.
Ask them “what happens when the original injection wears off” and if they don’t immediately understand the staggering problem I just explained, walk away because they don’t know enough about this to be fixing your face. The correction itself is usually conservative dosing: maybe two to three units on the unaffected side to create balance without over-freezing you into a joker smile from too much relaxation of your depressor muscles.
Speed Up Recovery (Maybe)
Some providers suggest infrared laser treatments or radiofrequency to increase blood flow and potentially speed up how fast your body metabolizes the Botox, but the evidence is mostly anecdotal and these treatments aren’t cheap and insurance definitely won’t cover them. Massage won’t help despite what you might read online: it won’t speed anything up and might actually spread the Botox further.
Living With It Until It Resolves
Practical stuff: take smaller bites when eating, use regular cups instead of straws since your lip control is compromised, wipe your mouth more frequently, and maybe tell close friends what happened so they stop asking if you’re okay. You can try strategic makeup contouring to minimize the visual asymmetry slightly but honestly it’s still going to be noticeable and you just have to accept that for however long this lasts.
The mental health piece is real: this is genuinely distressing and it’s okay to be upset about it because it affects every social interaction and how you present yourself to the world. If it’s really affecting your emotional wellbeing talk to someone because the psychological impact of looking in the mirror and not recognizing your own smile is not nothing.
How to Never Let This Happen Again
Only get Botox from board-certified plastic surgeons, dermatologists, or maxillofacial surgeons with years of experience, not months. Look at their portfolio specifically for lower face work. Avoid med spas running Groupon specials or anywhere doing high-volume appointments where you never meet your actual injector beforehand.
The lower face – anything around your mouth, along your jaw, near the oral commissure – is high-risk territory that requires serious expertise in facial anatomy and injection techniques, so if you must do masseter reduction or DAO treatment or anything else down there, only trust someone who’s been doing this since the early 2000s when this stuff first became popular and who has the experience to handle complications if they arise.
And follow aftercare like your face depends on it because it does: stay upright for four hours minimum after your Botox treatment, don’t rub or massage the area, avoid heat and exercise for twenty-four hours, and don’t lie face-down or do anything that might cause migration.
Related: How To Find The Right Botox Practitioner
The Bottom Line
Your crooked smile will go back to normal. That’s not a maybe, that’s a definite, because the effects of Botox are temporary by design and your facial expression will return once your overactive muscles can function again. Whether you wait it out or get corrective treatment, this is fixable and it has an end date even though right now it feels endless. You’re not stuck with this forever, you now know way more about facial muscles and depressor labii and masseter muscles than you ever wanted to know, and you’ll never make the mistake of choosing an inexperienced injector again. In a few months this will be a story you tell about that time Botox went wrong, not the reality you’re living every day.
