[7] Injection too superficial or too deep can lead to inadvertent injection of the wrong muscle, potentially causing an opposite effect from the desired outcome. The muscles of facial expression are innervated by terminal branches of the facial nerve.
For example, when injecting into the orbicularis oculi around the eyes — an effective method of treating crow's feet and creating a larger eye appearance — delivering the toxin too deeply can result in a highly raised brow and an unnatural look.
After receiving Botox, it's important to monitor the results for signs of complications. Common indicators that Botox may have gone bad include drooping eyelids, uneven results, excessive bruising, or prolonged swelling beyond the expected recovery period.
Botox is injected directly into the muscles and does not typically come into contact with the nerves. However, in rare cases, the needle used to inject the Botox can cause nerve damage. This type of nerve damage is called peripheral nerve damage and can cause pain, numbness, or weakness in the affected area.
Injecting too much Botox can create an unnatural look with asymmetrical features that might be impossible to reverse immediately. To prevent undesirable results of your Botox treatment, ensure your provider is medically trained, experienced, and follows all safety protocols.
The key danger zones of botox include the areas around the eyes and mouth, specifically involving the orbicularis oculi muscle, the facial artery, and the temporal artery. Think of these zones like a “no-go zone” on a map—trespassing can lead to hazardous results.
The majority of effective Botox treatments are administered from the cheekbones upward. Injecting outside these zones or into the wrong facial structures can result in a “frozen” look or, worse, impaired facial function.
Botox blocks nerve signals to muscles. As a result, injected muscles can't contract (tense up). These effects are always temporary, but can last for several months. The muscle injected depends on the primary area of concern.
Unlike some veins, nerves are not visible from outside the body, although you will definitely know if you've hit one while injecting because you'll experience extreme pain and no blood will enter the syringe when you pull back to register. You may feel an electric “burn” along your limb.
FDA has reported adverse events after BoNT injection affecting nervous system far from initial site of injection such as speech disorder, nystagmus, restless leg syndrome, and even coma. Central nervous system involvement included 23.5% of serious and 24.9% of non-serious events (1).
Possible side effects and unwanted results include: Pain, swelling or bruising at the injection site. Headache or flu-like symptoms. Droopy eyelids or crooked eyebrows.
Can bad Botox be reversed? It depends. While the Botox that was already injected cannot be "uninjected" after the fact, a skilled plastic surgeon may be able to strategically add more Botox or dermal fillers to other areas of your face to create a more symmetrical and balanced appearance.
Key muscles/ anatomical locations to avoid (and associated presenta- tion) include the following: frontalis (mid brow ptosis), levator palpebrae (lid ptosis), levator labii superioris alae- que nasi (lip ptosis), zygomaticus (lip ptosis), orbicularis oculi (diplopia), depressor labii inferioris, mentalis, and depressor ...
Too much Botox in the frontalis muscles can cause the eyebrows to arch too high on the forehead. The face looks surprised all the time. Too much Botox in the forehead muscles can cause the eyebrows to droop, making the upper eyelids look very heavy and hooded. The face may look angry or sad all the time.
How long does it take for Botox complications to appear? Complications from a bad botox session can appear within a few hours to a week after treatment. Monitor your results closely during this period.
People suffering from injuries because of a problem with a treatment or surgery can file a medical malpractice case against the treating medical professional. To win a malpractice lawsuit, plaintiffs need to prove that the medical professional violated the standard of care for their field.
Serious adverse effects after cosmetic use of botulinum toxin include dysphagia, muscle weakness, and allergic reactions [22, 23].
“In the frontalis, a deep treatment is likely to cause pain if you manage to hit the periosteum. However it's unlikely to affect the aesthetic result”, she continues. When treating the orbicularis oculi area, Dr Lindsay notes that “a deep injection could diffuse to the zygomatic muscles causing smile asymmetry.
When injected properly by a medical doctor, you can expect to see results after your first treatment. It can take two to four days before the weakening of the muscle begins and movement is stalled. You can see the maximum results of your treatment anywhere from ten to fourteen days after treatment.
Around the Mouth/Lip Area
Injecting botulinum toxins into the mouth area can cause a loss of emotional expression and asymmetry, as well as drooping as a results. While it is possible to inject Botox (botulinum toxin) in the muscles around the mouth, it's highly recommended that you avoid injections in this muscles.
Given the variation in depth along the course of the corrugator supercilii, injecting too superficially medially can lead to inadvertent injection of the frontalis muscle, causing brow ptosis rather than elevation. In addition, diffusion of toxin into the levator palpebrae superioris can lead to eyelid ptosis.
The Frontalis is the muscle in your forehead which controls the raising of your eyebrows. After 2 weeks, if you still feel heaviness, try gentle eyebrow raising exercises and blinking your eyelids rapidly for 30 seconds. Do this 4 times daily for 2-4 days as it may help resolve the heaviness.