Can photobiomodulation be an antidote to botulinum toxin?

Purpose Although botulinum toxin (BT) is a safe and well-established method for chemoimmobilization of facial muscles, undesired results can occur. The reversal of the effects of BT is poorly documented in the literature. This work describes how photobiomodulation (PBM) was used to reverse unwanted results from the application of BT to the lower face in a patient with aesthetic and functional complaints (asymmetry, difficulty speaking, whistling, eating, and controlling saliva). Methods PBM (808 nm, 100mW, 0.35 W/cm 2 , 10.7 J/cm2) was performed on the upper and lower labial muscles and chin to reverse the BT applied 14 days ago. Irradiation was performed at each point with the laser tip in contact with the skin for 30 s at each point (3 J), totaling 72 J per session (20 points). Results After two sessions (one-week interval) of PBM, there was an improvement in lip movements, with restored function. Conclusion In the parameters used, PBM was able to reverse the effects of BT on the lower face.