An unnatural result after the injection
The reason why results sometimes look unnatural is that some facial muscles are connected and it is not always possible to treat only the desired muscle. Sometimes there is also excessive contraction of a part of a certain muscle after relaxation of another area of the same muscle. Excessive shrinkage can be seen on the side of the forehead, creating an unnatural brow lift on the side of the brow.
Sometimes after injecting botulinum toxin on the sides of the eyes, an unnatural smile is created or a smile that does not include the eyes, only in the central and lower part of the face. It can look strange and unnatural. Mainly a smile that does not involve the area around the eyes, giving a contrived, unnatural and strange look.
It is important to maintain a natural movement when raising the eyebrow and it is also important to avoid reaching certain areas in order not to touch the cheek muscles that participate in smiling. Spillage of botulinum toxin into the cheek muscles creates a very unnatural smile and even drooping of the lateral part of the lip.
Captain Spock’s eyebrows
‘Excessive lifting’ of the lateral third of the eyebrow. This phenomenon is called SPOCK SIGN after Captain Spock, from the popular series and in which the surprised look is evident. This problem arises due to excessive treatment relative to the center of the forehead. The central part of the eyebrow has decreased relatively and thus the level is created more in the side area of the eyebrow. This is exactly the surprised and frozen look we fear so much.
Skill in injecting the forehead is of particular importance. An incorrect injection will affect both the position of the eyebrows at rest and the movement which may be unnatural. This is exactly the way to the “injected look” that we all don’t want so much. It is also important to remember that not everything is possible. It is not always possible to properly treat forehead wrinkles without adversely affecting the position and movement of the eyebrows.
The mouth drops
When the mouth droops, it means that the botox that was performed is not correct. This may happen as a result of an incorrect dose or an overdose of botulinum toxin. In general, an injection of botulinum toxin around the mouth or in the jaw area to lift the sides of the mouth should be done very carefully, since there may be a spillage of material to other muscles that are located nearby and there is no way to reach them.
In addition, you should know that the anatomy of the muscles is quite the same, but there are differences from person to person. Moreover, there are differences between the left and right side in the same person. Everyone is a little different and reacts a little differently to treatment, so each patient should receive the appropriate approach and treatment.
You don’t feel or see a difference
You can usually see a significant improvement after the injection, but sometimes the difference is not significant. This could be due to the laxity of the tissue or that higher doses are needed to get the same result. Sometimes after repeated injections of botulinum toxin for years the effect of the treatment becomes less significant.
We see the results of the treatment about two weeks after the injection and the effect of the Botox is only temporary and remains between 3 and 4 months, sometimes a little longer. It is worth remembering that immediately after the injection the result is still not visible and you have to wait two weeks to evaluate the success of the treatment.
New wrinkles are formed
When there is an area injected with Botox, you can sometimes see the appearance of new wrinkles in other and new areas that were not there before. Sometimes such wrinkles can be seen on the sides of the nose or on the inside of the eye, or on the side of the eyebrows. It is recommended to treat these wrinkles also with botulinum toxin and thus avoid their formation in the future.
Less is more
Although treatment with botulinum toxin seems simple, it requires a lot of knowledge and experience that needs to be gained in order to treat in an effective, safe way and to get natural and not “injected” results. Today, we tend to relax the muscles in a balanced way and thus achieve a “natural”, customized look after the treatment and thus both get excellent results and prevent some of the aging processes in the face. It is worth remembering that you can always come for a review between two to four weeks after the treatment and add more botulinum toxin to get the best possible result.
Dr. Innes Werner, specialist in dermatology