Can Botox for 11's Cause Wrinkles in Other Parts of the Face?

I've been getting Botox injections for my 11's for the past year now but since then, I've noticed more lines around and under my eyes when I smile that were never there before. So it started me wondering if the Botox was somehow pushing wrinkles into other areas of my face that were never there before. Your professional advice is greatly appreciated.

Doctor Answers 15

Can Botox to 11's cause wrinkles elsewhere?

The answer to your question is "yes" and "no".  While Botox can relax muscles in between your brows (your 11's), there are other muscles on the face that may overcompensate and cause wrinkling in another area.  We often will call this muscle recruitment.  The muscle that tends to overcompensate when the "11's" are treated is your frontalis (forehead) and it tends to settle down several weeks after your injections.  You describe more wrinkles around and under your eyes, which is most likely NOT due to overcompensation or muscle recruitment, but rather natural aging and not treating those areas with Botox.  I would discuss these areas with your injector to see if treating those areas with Botox are appropriate for you.

Rogers Dermatologic Surgeon
5.0 out of 5 stars 4 reviews

Wrinkles After Botox

Muscle recruitment can account for some new lines in other areas that have not been previously treated with a neuromodulator like Botox.  One must also keep in mind that facial aging also continues. With both bony and fat atrophy that occurs with time, your muscles are contracting onto a volume that may not be as robust as it used to be, accounting for new lines forming with age.

Sabrina Fabi, MD
San Diego Dermatologic Surgeon
5.0 out of 5 stars 83 reviews

Can Botox Cause Wrinkles?

Hi Jenna.  When Botox is used correctly between the eyes, it would not cause wrinkles under the eyes.  While it's possible for Botox to "migrate", it's very difficult even with bad injection technique for Botox injected between the eyes to migrate below it.  

What's more likely is that you are seeing wrinkles below the eyes either because the aging process is naturally revealing them or because the focus of your concerns has moved on from the frown lines to a new area.  

Harold J. Kaplan, MD
Los Angeles Facial Plastic Surgeon
4.3 out of 5 stars 6 reviews

More wrinkles after Botox

I would agree with Dr. Pearson's post - muscle recruitment and/or compensation from other areas is very common when one area is regularly treated with Botox.

Sam Naficy, MD, FACS
Seattle Facial Plastic Surgeon
4.7 out of 5 stars 221 reviews

Can Botox for 11's Cause Wrinkles in Other Parts of the Face?

Thank you for your question, Jenna. In general, when used correctly, Botox does not displace wrinkles from one area of the face to another. However, in an attempt to compensate for the muscles affected by Botox, nearby muscles may be 'recruited' to aid in facial movement. That process may unmask the appearance of dynamic wrinkles in adjacent facial areas. Additionally, following treatment with Botox and improvement of the noticeable dynamic wrinkles, wrinkles that were previously unnoticed may seem more apparent. If pre treatment photos were taken, it may help to review those to check as to whether those 'new' lines were in fact present before treatment. Raise your concerns with your Plastic Surgeon or Dermatologist who may be able to offer more specific advise in your particular case. Good luck to you.

James M. Pearson, MD
Los Angeles Facial Plastic Surgeon
5.0 out of 5 stars 129 reviews

Botox in 11's will not cause wrinkles under the eyes

Botox around the eyes for crows feet can sometimes accentuate wrinkles under the eyes caused by movement of the cheeks when smiling if not done carefully, but Botox in one area will not cause wrinkling in a totally separate, unconnected area.

Lawrence Osman, MD
Los Angeles Dermatologic Surgeon
5.0 out of 5 stars 5 reviews

Botox and wrinkles

Botox will not induce wrinkling elsewhere specifically, but what you may be noticing is recruitment in other areas causing wrinkling of the skin as you try to compensate. 

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 28 reviews

Botox can not induce wrinkles in other areas of the face

Botox injections into the Glabellar area produce only regional effects. In other words only the immediate regions treated will have any results. It does not migrate in most cases unless aggressively massaged immediately after treatment. This is an issue really only for the upper eyelids, which is undesirable. In your case I can tell you that new wrinkles under your eyes are completely unrelated to your Botox treatments. You might wish to have your crows feet treated with Botox and this may resolve the issue. Good luck!

Curt Samlaska, MD
Las Vegas Dermatologist
5.0 out of 5 stars 4 reviews

Can Botox for 11's Cause Wrinkles in Other Parts of the Face?

 Botox injected into the Glabella area (the 11's) relaxes the local muscles but other muscles adjacent to that area can continue to contract causing wrinkles and lines to be evident.  These can be softened with smaller doses of Botox.  Botox should not travel long distances, within the tissues or bloodstream in aesthetic doses, to impact and weaken other muscles.  Hope this helps.

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.6 out of 5 stars 24 reviews

Botox Should Not Create New Wrinkles

Hi Jenna,

An experienced Botox injector evaluates the muscle function of each patient and adjusts their treatment accordingly.  In your case, it sounds as if you should have some Botox or Dysport placed around your eyes appropriately.  Choose your injector most carefully.  Good luck and be well.

Dr. P

Michael A. Persky, MD
Encino Facial Plastic Surgeon
4.8 out of 5 stars 36 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.