As an intermediate Botox-er (I’ve had it done only a small handful of times), I went into my last appointment without hesitation. I’ve done it before, what would I have to be afraid of? A few days after the treatment, I had a creeping feeling that I didn’t quite look like myself anymore. Not in the my-lines-are-gone-and-my-forehead-is-poreless type of way; my brow felt heavy and I could tell that my eyes didn’t look as open as they usually do.
Then it hit me: I had become a casualty of Botox gone awry. The results have now worn off, but ever since, I’ve been curious about what went wrong. I decided to chat with FACILE dermatology + boutique Co-Founder Nancy Samolitis, MD, FAAD, all about what a bad botox treatment looks like, why it happens, and what you can do to help if you, like me, find yourself unhappy with results. And now I’m pretty sure that I napped a little too soon after treatment…learn from my mistakes!
When Botox “goes bad”, that usually means that the active molecule diffused into a muscle that was not intended to be treated. For example, when the injections are done for the frown line between the brows, the eyelid muscle can be affected causing a heavy eyelid or when the chin is treated, the lower lip smile muscles can be affected causing an unnatural or asymmetric smile. In many cases, the forehead can be the least forgiving area with incorrect injection points leading to flattening of the brow or excessive peaking of the brow [sometimes known as “spocking”]. This may happen on both sides or one side and is easily recognized as “Botox gone wrong,” Luckily, all of these problems can be corrected by an injector who understands why the problem occurred and what to do to change the muscle activity.
The wrong muscle can be treated by an injector who does not understand anatomy including the variations that occur in different people. A well-educated injector rarely makes these “mistakes”, but everyone’s anatomy does not always follow textbook rules, so occasionally, imperfect results can occur in any case. A good, reputable injector should recommend a follow up in 1-2 weeks when the treatment is fully kicked in so they may determine your response and correct any asymmetry or undesirable outcome. An inexperienced or uneducated injector can potentially cause many complications including changing your natural smile, causing areas to look frozen, or even more serious complications like difficulty swallowing.
If you are unhappy with your result, ALWAYS go back to your injector to express your concerns. If your injector is experienced and ethical, they will most likely correct you at no charge. We strive to produce an ideal result in everyone, but it sometimes takes a few treatments to get to know how your body responds. If your injector is unwilling to help you, get a second opinion.