Botulinum toxin is used in facial paralysis to quieten muscles that are pulling too hard, whether on the strong side or on a recovering side that has become tight. It is a clinic treatment, not an operation.
In facial paralysis, botulinum toxin has two jobs. On the healthy side it softens muscles that overpower the weak side, which evens out the face at rest and in movement. On the affected side it relaxes muscles that have become tight or that fire at the wrong moment during recovery. The effect wears off over months and is then repeated.
It seems odd to weaken muscles in a face that is already weak. The logic becomes clear once you watch a palsy in a mirror. The healthy side keeps its full strength and pulls unopposed, so the mouth drags across, the eyebrow sits higher and every expression exaggerates the difference. Softening a few muscles on that side reduces the mismatch, and many patients feel the improvement before they can see it.
The second use concerns the recovering side. As nerve fibres regrow after an injury, some reach the wrong destination, so the eye narrows when the person smiles or the mouth twitches when they blink. Tightness in the cheek and neck can accompany it. Very small doses placed precisely in the overactive muscles reduce that pulling and give physiotherapy room to work.
Injections are given in clinic with a fine needle. Numbing cream is available and the appointment is short. Effects appear over several days, build over a couple of weeks and then fade gradually, which is why the plan is a series of visits rather than a single treatment. Records of dose and site guide each subsequent session.
Injections suit people who want a non surgical way to improve balance, and those troubled by tightness or unwanted linked movements.
Your face is watched at rest, smiling, blinking and speaking, often on video. Overactive muscles are identified and marked, because the target differs from one patient to the next.
A conservative dose is chosen at the first session. Starting low and reviewing is safer than aiming for a large change immediately, since the effect cannot be undone once given.
Numbing cream can be applied beforehand. Several small injections are given with a fine needle, and the session usually takes only a few minutes once planning is complete.
The face is reassessed once the effect has developed. Small top ups can be added at this point if a particular muscle is still pulling too strongly.
Treatment is repeated when the effect fades. Records of every dose and site make each session more precise than the last.
Tiny marks or slight bruising may show at injection points. Normal activity continues, though heavy exercise and rubbing the area are avoided on the first day.
The effect develops gradually. Tightness eases and the pull from the strong side softens, and the full result becomes clear towards the end of this period.
The face has settled into its new balance. This is usually the most comfortable phase, and therapy exercises tend to feel easier.
The effect fades and muscles regain their previous strength. Most patients return for repeat treatment before the old pattern fully reappears.
Injections rebalance a face, they do not reanimate it. The paralysed side gains no movement, so what improves is the contrast between the two sides. Many patients find that a softer strong side makes the whole face read as more even, especially in conversation and photographs. The effect is measured in months, and doses often need adjusting over the first few sessions before the pattern that suits you is settled.
Side effects are usually mild and pass as the effect wears off, though they should be understood beforehand.
Very little is needed, and the few instructions given are mostly about the first several hours.
They reduce pull rather than create movement. Balance improves because the strong side is calmer, not because the weak side has woken up.
Doses used in facial palsy are small and targeted. The aim is a natural balance, and the dose is adjusted at review if expression feels reduced.
The effect wears off over months, so repeat sessions are part of the plan from the beginning.
Easing tightness and unwanted linked movements is a functional gain, and many patients report real relief from discomfort.
Elegance Clinic in Surat treats injections as part of a long term facial palsy plan, and Dr. Ashutosh Shah keeps a record of every dose and site so each session builds on the last.
Injection treatment is charged by session rather than as a single course, because the number of visits varies from person to person. The estimate reflects the amount of product used, the areas treated and the review appointment that follows. Since the effect fades over months, the likely yearly pattern is explained at the first visit so you can plan. You receive a written estimate after assessment, and any change in dose at review is discussed before it is given.
These are the questions that come up most often in consultation. If yours is not here, send it on WhatsApp and the team will reply, usually the same day.
Ask your question →Because it pulls without opposition. Softening a few muscles there reduces the contrast between the two sides, so the mouth is dragged across less and the face reads as more even at rest and while speaking.
Several months in most patients, then it fades gradually as the muscles regain strength. Repeat sessions are planned before the old pattern fully returns, and the interval that suits you becomes clearer after the first year.
A fine needle is used and most people describe brief stinging. Numbing cream can be applied beforehand if you prefer. The session is short, and normal activities can be resumed the same day.
A written estimate is given after assessment and reflects the product used, the number of areas treated and the review visit. Costs are quoted per session rather than as a package, since needs change over time.
They serve a different purpose. Injections reduce pull and ease tightness, while surgery restores closure or movement. Many patients use both, and injections are often continued after reconstruction to fine tune the balance.
Repeat treatment over years is common in facial palsy care and is generally well tolerated. Doses are kept as low as the result allows, and each session is recorded so patterns of response can be tracked.
Usually not straight away. Time is given for natural recovery, and injections tend to be introduced once the pattern of weakness, tightness or unwanted linked movement has become clear at review.
Seeing patients from across the city and beyond: read about the practice on the plastic surgeon in Surat page, or check what a written estimate covers on the costs and insurance page.
