When neuromodulators are done right by the right person, they are great. when you get it wrong, it’s not unreasonable that it’s not the best look. “Some telltale signs of ‘bad Botox’ are asymmetry of facial movement, excessive brow lift and unnatural brow shape, noticeable upper lid coverage, ‘frozen’ look and some lines becoming smoother and others appearing exaggerated ”, explains New York. facial plastic surgeon Konstantin Vasyukevich, MD, who offers these three lines of advice: “Do your research. Find out what result you are looking for. Please explain your preferences to the injector in detail.”
Sign 1: You didn’t get the real deal.
For starters – and we can’t stress this enough – you should only go to a board-certified plastic surgeon, facial plastic surgeon, or dermatologist to get any type of injection. From there, Troy, MI, plastic surgeon Anthony Youn, MD, says he recommends asking your provider where the neuromodulator comes from or doing a quick search online if in doubt. “Ask if Botox was purchased directly from Allergan in the United States. This is really the most important question. You can also go online to see if the provider is listed on the Allergan website of official Botox providers.
Sign 2: Or you made too much of a “good deal”.
Dr. Grossman advises to be wary of “specials” that seem too good to be true, because they probably aren’t legit. “Maybe this doctor doesn’t use brand name products – remember the chiropractor in Florida who sent people to the ICU to inject boot product imported from China? Discounts are usually a sign that injectors are using a one-size-fits-all treatment protocol.” Likewise, New York-based dermatologist Jody A. Levine, MD, emphasizes keeping an eye out for opportunities. “There are so many people getting injections these days who don’t fully understand the facial muscles and the science behind how Botox works. Botox should not be treated as a product you buy, for which you try to get the best price, but rather as a procedure you have done, for which you want the best result.”
Point 3: Your doctor went with a “pattern” for injections.
This is a bit tricky, but there are ways to avoid it. “There’s a science and an art to neuromodulators, fillers, lasers, and surgery,” says Santa Monica, CA, dermatologist Karyn Grossman, MD. “Unfortunately, many people go to evening training classes where they are given a template and learn how to inject to match the template. It works, but it freezes/paralyzes the muscles and doesn’t take into account a person’s unique characteristics or muscle patterns. So everyone comes out frozen and like a mask.” So how can you avoid it? “The best thing to do before injecting is to look at people who have been treated by that practitioner. Do they have the look you want? Are they more natural or more frozen?’
Point 4: Your doctor has ignored you.
In another nod to the fact that there is no “one size fits all” when it comes to neuromodulators, Dr. Grossman says your injector should be looking at your face, analyzing your muscle movements and forces. “Is he asking you how you want to look? Does it ask for the results/results you desire? These are all important questions.” Plastic surgeon George Sanders, MD, Encino, CA, also advises that good old “go with who you know” route. “Get your Botox done in an office where you’ve had other procedures. They value you as a patient and would never do anything to harm that relationship, such as giving you diluted botox, etc.”
Sign 5: You don’t look natural when you’re resting—or when you’re moving.
“Not looking natural” is a vague term, but Scottsdale, AZ, facial plastic surgeon Kelly Bomer, MD, breaks it down in relation to neuromodulators: “My definition of ‘Bad Botox’ is an effect that looks unnatural at rest or in motion. . It is important to ask about maintaining the natural movement of the brow lift when actively raising the brow and the normal lift of the cheeks when smiling. A common ‘Bad Botox’ effect is the ‘Spock Brow’, where the tail of the brow is unnaturally high and sharp and the middle brow is unnaturally low. And for the crow’s feet area, if Botox is injected in a pattern that reduces cheek lift, hollow eyes and nutmeg cheeks can be seen.
Sign 6: There’s something REALLY different about your brows.
In another nod to the eyebrow equation, Dr. Bomer points out that if your side brow lifts during the natural brow lift before Botox Cosmetic, and if while the forehead is being injected there are no forehead injections above the side brow, this will lead to the “Spock Brow.” “Not every brow naturally lifts laterally, so not every person needs a lateral forehead injection to maintain a natural look. If your eyes look hollow before Botox, it is helpful not to inject into the upper cheek/side of the eye, as this will make the eyes more hollow and push the cheek out unnaturally when you smile. Better to keep the injection in the side eye and up to lift the tail of the brow without the cheek dropping.”
Sign 7: Suddenly, you have a “mouth problem.”
Dr. Grossman agrees that the eyebrows can be a prime area to show when something is wrong, as can the mouth. “If your eyebrows have fallen to your lashes, you look like you’re auditioning for the next one Star Trek, or your mouth is drooping, you had “bad botox”. These are nasty things that can happen from the wrong or overdose of neuromodulators. They’re not permanent, but they can be debilitating while you have them.”
Sign 8: You’re having an adverse reaction.
Dr. Youn says that any adverse reaction, allergic reaction, or side effect after Botox—changes in vision, increased pain, increased swelling, etc.—should prompt you to call your doctor to make sure everything is okay. .
Sign 9: You don’t see a difference.
“There are bad side effects, like those listed above, or Botox just doesn’t work [the wrinkles are unchanged a week later] they’re also signs that what you got may not be what you thought,” adds Dr. Yun, but it is important to remember that you may not see a result immediately. “Botox takes about 7 to 14 days for most people to see the full effect after a Botox injection. In some patients, it can take up to three weeks,” says Dr. Bomer. “Because there is a period of time in the body for the Botox to work to relax the muscles, you have to wait until the Botox has fully taken effect to know if there was a heavy hand. It is difficult to know immediately after the injection if there is going to be an abnormal effect.”
Sign 10: New lines are actually forming.
Yes, Dr. Grossman says this can happen. “When an area is frozen too hard with Botox, you can see new lines forming.” The good news: “If your provider was boring, they will eventually go away. Unfortunately, the heavier the hand, the longer it will take. Also, long-term use of large amounts of neuromodulators—especially in the upper face—can lead to muscle atrophy over time. You might say it’s “good” and you’ll need less Botox in the future, but it’s not. Atrophy actually causes your face to age due to the loss of muscle volume. We now see women with smooth shiny foreheads with thin skin and low faces that are full of wrinkles.’
Sign 11: You have too much Botox.
“I always advise my patients that you can always add to Botox, but you can’t take it away,” says Dr. Levine. “It’s better to inject less and come back in two weeks for more than to start too much and then have to wait three whole months for the results to wear off.”
Sign 12: You see wrinkles right above your eyebrows.
It doesn’t sound like much, but Phoenix, AZ dermatologist Dr. Karan Lal says this is a skin sign that your injector probably didn’t inject “far” enough. “I see it all the time! While we focus on the muscle at the front of the forehead, we recruit from muscles outside of that area. Neurotoxin in these areas can prevent upper brow wrinkles.”
Sign 13: You see wrinkles on the upper part of the forehead.
Likewise, if you see wrinkles on the upper forehead, that means your injector probably didn’t inject along the hairline, explains Dr. Lal. “Injecting neurotoxin high up along the hairline can really give your face a good lift. If you skip this area, you will see wrinkles on the upper part of the forehead!”
