Botox Mistakes and How to Fix Them

Part 5 of 6: Botched Botox jobs and their solutions |

Botox spot eyebrows

When Botox is used appropriately, it is one of the safest treatments for reducing wrinkles. You can see real life proof of this in the before and after pictures of my mom's recent Botox treatment. However, Botox is expensive and some people get side effects, like bruising, that detract from the overall treatment experience.

Some people have negative experiences with Botox because of side effects. While most Botox side effects can be minimized, they tend to be reactions that just happen. Others have negative experiences with Botox because of botched Botox jobs. This is when they are unsatisfied with their Botox results because of errors in their treatment.

This section, Part 5 of 6, discusses these Botox mistakes and what can be done to fix them or prevent them from occurring.

Botox Mistakes and How to Fix Them

Cosmetic Botox is a precision treatment and requires the skill, technique, and know-how of a well-trained and experienced dermatologist or plastic surgeon, preferably a physician who has many years of expertise in facial anatomy. Botched Botox jobs are usually the result of mistakes made by the Botox injector and these Botox mistakes include:

  • Overtreatment - Using too much Botox can give you a "frozen face" where it seems like nothing on your face moves (especially in the forehead and glabellar region) but your mouth. Your face ends up looking blank, expressionless, plastic, hard, and unnatural. Believe it or not, some physicians and patients actually go for this kind of paralysed look! However, more often than not, post-Botox "frozen face" happens when Botox is inappropriately administered.

    When Botox is used to reduce wrinkles, the goal is to soften negative expressions (like frowning, crow's feet), not to completely eliminate your ability to make facial expressions. It takes a skilled and experienced physician to minimize negative expressions while maintaining "normal" positive expressions (like smiling) without immobilizing the entire face.

    Solution: Overtreatment of Botox is temporary and the effects will go away once the Botox wears off. This can take anywhere from a few weeks to a few months. To prevent overtreatment of Botox, make sure you and your Botox injector are on the same page as to what results you hope to achieve. Always choose a board-certified, reputable, and experienced physician who's expertise is facial anatomy.

  • Undertreatment - Undertreatment of Botox occurs when Botox results wear off too fast or when Botox "doesn't work." This can happen if you get "watered down" Botox from a less reputable doctor or if you simply don't get enough Botox units for your anatomy. However, some people are more resistant to Botox and therefore might find a standard injection to be ineffective.
    Solution: Get a Botox consultation to make sure you are a good candidate for the treatment. Make sure you understand what Botox can do for you and make sure your physician knows what you wish for the Botox to do. Again, go to a board-certified and skilled Botox injector for the most precise results.

  • Drooping - Drooping eyelids or eyebrows are two of the most common Botox complaints. In most cases, post-Botox drooping is not true eyelid ptosis (discussed below) but rather the result of improper Botox application (usually injecting the Botox too low, too deep, or too much).

    This is what causes the apparent drooping: When Botox is injected into your forehead, it freezes the frontalis muscle that is used to lift your eyebrows. When this muscle is relaxed, it can make your forehead feel heavy, especially if you have a habit (conscious or not) of lifting up your brows. When your forehead is relaxed and thus heavier, your brows might drop and feel lower as a result. And since your brows are right above your eyelid and your eyes don't have anywhere to go, when your brows descend, your eyelids can end up feeling lower and looking droopy. This is more pronounced if you have hooded eyelids, if you have excess skin above the eyes, or if you have a habit of raising your brows to try to open up your eyes. So in essence, it's not that your eyelid is really drooping. It just looks like it has drooped because it's been pushed down.
    Solution: There isn't a quick fix for post-Botox drooping that is not true ptosis. You simply have to wait for the Botox to wear off. Make sure you go to a doctor who is experienced with injecting Botox in the forehead and around the eyes. If you are worried about potential drooping, you may ask your Botox injector to be more conservative with the treatment. Again, get Botox done by an experienced medical professional for the best results.

  • True eyelid ptosis - Many people who experience post-Botox drooping have the kind of apparent drooping discussed above. True eyelid ptosis (eyelid drooping) is rare, but unfortunately, it does happen and is usually a novice Botox injector's mistake.

    Eyelid ptosis occurs when the muscles that control your eyelid (levator palpebrae superiorus and levator aponeurosis) are Botoxed. Botox can either be mistakenly injected into these muscles or the Botox can spread to these muscles after being injected somewhere else. Since Botox freezes muscle contraction, having the muscles that control your eyelid be frozen means that your eyelid will droop or close. If you have any kind of trouble with your eyes after getting Botox, contact your doctor immediately.
    Solution: Eye drops (iopidine 0.5% or apraclonidine 0.5%) can be prescribed to alleviate eyelid ptosis, but you have to wait for the Botox to wear off before your eyelid function returns to normal. Using a less diluted Botox solution can prevent the Botox from spreading, but eyelid ptosis is usually committed by a novice injector. Make sure you get your Botox from an experienced doctor who knows how and where to inject Botox around the eyes. It pays to be conservative with Botox injections in this delicate area because you can always add more Botox later, but you can't remove Botox once you inject it.

  • Lopsided features - Botox can sometimes give you asymmetrical results, whether it's Spock eyebrows (where one eyebrow is raised and the other isn't) or a lopsided smile. Lopsided features can either be from poor Botox placement or simply from having different facial anatomies that react to Botox placement differently.
    Solution: Lopsided features can usually be fixed by adding more Botox in certain areas of the face. Otherwise, you just have to wait for the Botox to wear off. Make sure you go to a highly skilled doctor to avoid this Botox mistake, especially if you are going to get Botox in the lower facial region.

While the effects of these Botox mistakes are temporary and go away once Botox wears off, no one wants to walk around with a half-closed eyelid or a perpetual quizzical brow. To avoid getting botched Botox, it is imperative that you get your Botox from a board-certified, experienced physician.

Ask your friends for doctor suggestions. Go to multiple places for Botox consultations so you can compare consistencies in treatment suggestions. If one doctor says one thing but the other doctor says something different, go to a third doctor to see what they think. Look at patient before and after pictures, but keep in mind that pictures can be touched up and doctor's offices usually select the most dramatic before and after Botox pictures to put in their patient albums.

Do your research and shop around for Botox expertise, not Botox cheapness. If there is a Botox "sale" going on somewhere (like a ridiculous 50% off Botox), avoid it like the plague. Good Botox injectors don't need to do this to get patients.

The next section will cover the things you should and shouldn't do before, during, and after Botox to ensure you get the best results. 


Last updated: November 15, 2012

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Part 6: Botox Do's and Don'ts