Botox®: The unwanted effects

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As we have said so many times before: Botox® is completely safe, and side effects are rare.  However, what happens when you don’t so much get a side effect as get too much effect?  And what can be done about it?

Botox should always be injected by a qualified professional (in South Africa that means doctors and dentists ONLY, not spa therapists who once knew a doctor who gave them Botox).  Your injector should assess your face and your needs and should advise you on what can and cannot be done with Botox.  For example, Botox cannot erase sleep lines or non-dynamic lines.  It cannot give you a facelift, and it cannot do anything at all without paralysing some of your muscles, and needs to be administered in doses that will achieve results.

Having said that, how much is too much?  We have already spoken about what can go wrong during or after a Botox treatment in terms of side effects including bruising and ptosis, and that information is important for each and every time you go for a treatment, but this post is not so much on side effects, but rather on unwanted effects from intentional injections.  These effects can happen to anybody, even in the hands of a trained and skillful doctor.

  One of the most common complaints that we hear is “the last time I got Botox my eyebrows went too high.”  This may sounds like a ridiculous complaint, but if you’ve ever seen or experienced this you will know why in the industry it is called “Spocking”.  Dr Spock was fabulous, but his brow game wasn’t exactly desirable for us Earthlings.  This is what happens when a Botox brow lift goes wrong.  Botox can help to lift the brow about 2-3mm if injected accurately, however if the dose is too high or placed incorrectly the inner part of your brow will remain fixed and low, and the outer part will lift and can land up pointing towards your temple!    Anecdotally people say massaging the area or applying the back end of an electric toothbrush helps the Botox to work out of your system faster.

The second Botox mishap that can occur is when you get Botox for the horizontal lines that go across your brow, and land up with your brow falling into your eyes.  Many people don’t realize that as we age often the reason our horizontal brow lines tend to deepen is because we are constantly raising our brows to keep excess eyelid skin from obstructing our vision.  Getting Botox to these lines will paralyze the muscles that keep our brows up, giving us a wonderfully smooth forehead, but essentially allowing our lid skin to hang into our eyes making us look tired and somewhat blinding us.  Make sure your doctor has assessed you well before injecting this area.  A Blepharoplasty (eyelid tuck) is a lot more expensive and requires more downtime, but it will certainly prevent the horizontal lines and will refresh your look completely if this is something you suffer from.

Bunny lines are another telltale sign of too much Botox.  This is only really a problem if these are the only lines that form on your entire face, because then they become quite obvious.  If you are naturally someone who forms Bunny Lines, or if you only make them when you scrunch your nose up it is NOT NECESSARY to treat these!  When the rest of your face is static and the only thing that moves is your nose you can imagine how this begins to look a tad unnatural.  Once again the remedy is to zap these little lines with a splash of Botox if you are forming them too much to prevent them from deepening and becoming permanent.

Chin Botox is gaining in popularity and with more and more treatments being done we are seeing more and more complaints.  The chin muscle is a sneaky puppy because instead of attaching to a bone over a joint, it actually attaches to the overlying skin, much like a perlemoen or a limpit or some other kind of sea creature (our sea creature knowledge fails us).  SO instead of having one attachment it tends to have many tiny “feet” stuck to the skin of our chins, which gives us the orange-peel effect when we turn our lips downwards and jut our chins out.  What can then happen with a Botox injection is that a few of these “feet” somehow escape the effects of the Botox, and like sneaky little ninja’s they continue working when the rest of the muscle has been paralyzed.  This kind of problem isn’t so noticeable in other muscles, but in the chin these little feet tend to pull, creating dimples while you are speaking that weren’t visible before.  Once again, the solution is a few more units into the offenders and you should see an improvement within a few days.

The key to sorting out any unwanted effects from Botox is really communication.  Choose a doctor who you trust and who you know will make themselves available to talk or for a quick follow up any time you have a problem or a question.  The solution to these problems is usually patience or more Botox, and it’s best to know which one you should be going for.  With all Botox-related problems rest assured that none of them are ever permanent.  If you have a side-effect that turns you from the stuff for life, know that within 3 months all the Botox will be gone and your face will be back to square one again.  Botox is incredibly safe and in fact beneficial in trained hands.

To find out more about Botox treatments visit our website or give us a call on (021) 683 3048 extension 1.  Alternatively pop us an email on

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