5 Aesthetic Complications of Botox: What you should know before you get injected
Botox is one of the most popular aesthetic treatments, not just in Boston but around the world. From your neighbor, sister, and favorite celebrity, it seems like everyone is jumping on the wagon to get them done. With its powerful anti-wrinkling benefits (in addition to a wide range of medical benefits), the procedure is highly alluring. Although Botox is a generally safe and well-tolerated procedure with highly satisfied results, there are still some unwanted complications that can occur.
For a quick refresher on how Botox works, click on our post titled, ‘Botox vs. Fillers.’
#1: Brow droop and heaviness
A somewhat common but bothersome complication that can arise after getting Botox in the forehead muscle (also called the frontalis) to treat horizontal forehead lines and wrinkles. There are several reasons why this may happen, and oftentimes they occur due to injector-based errors.
Your injector treated your upper forehead without injecting your eyebrow wrinkles (11s): The anatomy of the forehead muscles can be split between two groups— the eyebrow elevators (frontalis muscle) and the eyebrow depressors (corrugator supercilii, procerus, depressor supercilii, and the orbicularis oculi). The strength and pull of these two groups of muscle are delicately balanced, similar to a tug-of-war. When the upper forehead muscle, or frontalis, is injected with Botox, while the eyebrow depressors are not, the balance is tipped in favor of the eyebrow depressors, causing the eyebrows to droop or lower. This can cause eyebrow heaviness, hooded eyelids, and a general displeasing aesthetic appearance.
You’re used to raising your eyebrows: Sometimes patients who come in with hooded eyes or suffer from saggy eyelids caused by natural aging grow accustom to naturally and subconsciously raising their eyebrows to lift the tissue and skin over the eyelids. After getting Botox in the forehead, this ability to raise their eyebrows is deactivated, leaving a sensation of eyebrow heaviness. Although not a serious complication, it can still make patients feel uncomfortable and uneasy.
Your injector injected too deep on the lower half of your forehead: The right injector should be aware of the anatomy of the forehead when treating wrinkles. When injections are placed too deep on the lower part of the forehead, this targets the inferior (or lower) part of the frontalis muscle, causing it to be deactivated, and for the eyebrow depressors to become unopposed.
#2: Eyelid droop
We’ve all seen the viral TikTok video of the influencer who had received Botox in her face experience a drop or ptosis of one of her eyelids. The levator palpebrae is a muscle located on the top of your eyelid, responsible for retracting it and ‘opening’ the eye. Botox placed in the middle of the eye or too close to the rim of the eye can cause this muscle to be deactivated, disallowing the ‘opening’ effect. But fear not— this can oftentimes be remedied with eye drops.
#3: ‘Peaked’ or Spock eyebrows
This is occurs when the middle of the forehead and eyebrow muscles are treated, but the sides of the forehead are not, leaving them active. This can be solved very quickly at your 2-week follow-up by putting a small amount of product on the sides of the forehead to lower the eyebrow peaks.
#4: Smile asymmetry
An unfortunate effect that can arise with improper injection placements in the muscles responsible for creating a smile, most commonly the zygomatic major or minor and the risorious muscles. Although rare, this can occur when going for treatment of the crow’s feet, masseter muscle, or pout muscle.
#5: Bruising
This can be more a nuisance rather than an adverse complication. Believe it or not, the face contains a highly intricate network of many vessels, veins, and arteries. And despite our best efforts, sometimes nicking a vessel is unavoidable. There are ways to mitigate bruising, and we advise all our patients to refer to our pre-care packets for more information.
