Botox cause cheekbone to look less defined, dropping on one side/nerve damage? (Photos)

Question

I had Botox in my forehead crows feet and chin in dec of 2022. I have always liked my natural cheek bones, until now :( I noticed my face start to lose my normal natural detention in my cheekbones by March of 2022... could Botox have caused this? As well as asymmetrical dropping. My nurse injector said no but I feel like it could have caused it. I didn't noticed the uneven droop, and loss of detention in my cheekbones until mid March.

Anna Chacon, MD, FAAD · Answer

There are two signs you've had a bad Botox injection: Unusual results such as facial asymmetry (one side doesn't match the other), overarching eyebrows, a drooping eyelid, or not being able to move the forehead at all. In general, Botox lasts 3-4 months. There will certainly be patients in which in lasts longer, in that 4-6 month range, or shorter, in that 2-month range. It is also common for first-timers to notice that it may not last as long initially but may last longer after the second treatment.

Kenneth D. Steinsapir, MD · Answer

Mostly the differences are on the basis of lighting. Botox has basically worn off. However, it can still be a period of time before the training effect on muscle volume wears off. Perhaps someone other than a "nurse" should be doing your injections. Your lips seem to be bigger in the second image and not particularly natural. Removing filler volume from the face can also be beneficial and you should consider this option if you continue to have concerns about your appearance.

Jason Emer, MD · Answer

For unique cases where a variety of modalities could be used to treat the condition, I would suggest an in-person or virtual consultation to develop a custom and effective treatment plan.  It is difficult to precisely define the best option without collecting the same information. I suggest reaching out to an expert for a consultation with surgical and non-surgical methods to get a comprehensive option. Best, Dr. Emer.

Dr. Kim Facial Plastic Surgery - San Francisco · Answer

It is likely that botox diffused or migrated into the cheek muscles. This may cause your cheeks to temporarily appear lower or have an unnatural smile. As with all neuromodulation treatments, this will resolve over time, but can take up to 12 weeks or longer.

Camille Cash, MD · Answer

From the submitted photos and the description of your concerns they are unrelated to your Botox injections.  The effects of Botox are temporary, lasting three to four months on average.  If you are wanting to enhance your cheekbone area you can consider fillers such as Restylane Lyft or Juvederm Voluma.

Botox cause cheekbone to look less defined, dropping on one side/nerve damage? (Photos)

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