We all know what "bad"В Botox looks like-the scaryВ stuff associated with Beverly HillsВ housewives and HollywoodВ starsВ who have gone too far and can no longer move their facial muscles;В or, worse yet,В have what appears to beВ drooping eyes or brows.В
Whether you've experienced bad Botox yourself and are seeking answers, or have been too afraid to try it for fear of the worst case scenario, you'll want to keep reading. We spoke to dermatologic surgeonВ Dendy Engelman, M.D.,В of Manhattan Dermatology and Cosmetic Surgery,В to understand what happens when a Botox job goes wrong, and whether or not the damage can be undone.
So what exactly constitutes "bad Botox," and whatВ happens when Botox ends up looking scary,В instead of making someone look like a better, younger version of themselves?В Engelman categorizes bad Botox as falling into two camps:В "The firstВ is when it is very obvious that the patient has had Botox performed. This can manifest in browВ asymmetry,В lid ptosis (drooping eyelid),В and inability to move the forehead at all," she explains.В "The second would be when the patient is unhappy with the results."В
Risks of Getting Botox
"Most commonly, bad BotoxВ resultsВ becauseВ the rules of injection of neurotoxin and strict adherence to the knowledge of facial anatomy have not been followed," says Engelman.В Translation: Someone injected where they shouldn't have, and it looks bad.
"When neurotoxins are placed improperly, this can result in facialВ asymmetry (one side not matching the other), drooping of the eyelids orВ eyebrow, and double vision.В A badВ habitВ of old was to inject entirely too much product into the face, and this resulted in an expressionless face (because the patient was unable to make any movements to express emotions)," she explains.В "Thankfully, the injecting trends have steered away fromВ thatВ aestheticВ (in most markets), and I feel that change is for the better. The goal in neurotoxin administration is to give a more relaxed andВ youthfulВ appearance,В without appearing as though one has done anything."В
How to Ensure You Get The Best Treatment
We had Engelman break down exactly where a person should not inject Botox, and she explained that, in general, Botox is used from theВ cheekbonesВ and above, so,В "for lines between the brow, forehead wrinkles, and wrinkles around the eyes."В Botox is the only neurotoxin that is FDA-approved forВ both the brow and crow's feet region.В Engelman gave us this handyВ rule ofВ thumb to remember when it comes to Botox: "DermatologistsВ use filler from the cheeks to the chin and Botox from the cheeks to the hairline.В So, that said,В the ways to tell when Botox has been done incorrectly isВ if oneВ eyebrow goes up higher than the other when eyebrows are raised, if one eyelid or eyebrow looks lower than the other or appears to be drooping, and if a patient's smile looksВ asymmetric or unnatural-this can be a result of misplacement of neurotoxin or too much injected into the crow's feet region," she says.В
What to Do If You've Gotten Bad Botox
As for the million-dollar question on whether anything can be done to correct bad Botox, Engelman says thatВ it depends. "If too much is used and a person is left expressionless, this cannot be reversed," she says. The good news is that it's not permanent.В "The patient just has to wait until the neurotoxin wears off,В which is typically between ten toВ 12 weeks," says Engelman. (For the record, Engelman noted thatВ some people love theВ "frozen" look and request it).В
However, if the results are not quite even, there is something that can be done beyond waiting for the Botox to wear off. "If a patient experiences brow asymmetryВ (where one brow goes up higher than the other whenВ eyebrowsВ are raised), this is easily fixed by injectingВ aВ littleВ more product into the stronger side. This is a commonВ occurrenceВ and is easily corrected," she says.В
We were initially confused by this answer-addВ moreВ Botox toВ fix a browВ higher than its partner?В But Engelman explained: "This is a tough concept and a common misconception.В Contrary to popular belief, botulinum toxin (Botox) actually stops or limits muscle contraction, so it actually doesn't tighten muscles-it, in fact, does the exact opposite.В So, if a muscle is still contracting afterВ injection (leadingВ to a higherВ elevation of the brow on the stronger side), adding more into itВ will stop it from being so 'strong'В and will allow for the brow to lower,В leading to better symmetry."В
Know Your Pro
So remember that you won't be frozen forever, and always do what you can to prevent bad Botox from ever happening in the first place. Says Engelman, "Although it looks fairly straightforward, there is an extreme amount of knowledge that goes intoВ meticulous injection technique and solid knowledge of the underlying facialВ anatomy. Don't bargain shop for your face. Make sure youВ research who you are soliciting to inject toxins into your face. Make sure youВ always seek a licensed, trained,В board-certified professional. I promise that noВ amount of money saved is worth the potential for a bad outcome. Your face is worth the investment!"В
We also suggest going in for a consultation before you get the actual injections. What you have in mind as a correct injection placement could be different from what the doctor knows is the best option for the results you want.
Check out our story on other things to know if you're considering getting Botox.В