Severe edema/swelling 4 months after Botox injections (Photo)

Thank you very much for your question and pictures.
Unfortunately, without an in-person examination, it is difficult to provide a
proper assessment. However, at four months post-treatment, Botox is not the
cause of your swelling. The results from Botox will wear off in three months, so the injectable is no longer in your
system. I recommend contacting your board-certified Botox provider, so that
he/she can evaluate your symptoms and provide appropriate advice.

It is extremely unlikely that this anything to do with your BOTOX treatment since a majority of the product would have worn off by now.  Best to call the person who actually performed your injections and get their input.  I would also see an ENT to talk about possible allergy/sinus etiology for your concerns.I hope that helps and wish you the very best!Warmest regards,Gregory A Buford MD FACSBoard Certified Plastic Surgeon and Author

this cannot be related to the botox and could be related to any fillers or surgeries performed.  I would suggest getting your sinuses evaluated.  Please see an expert.  Best, Dr. Emer.

Thank you for sharing your question and photograph.  Unfortunately any effects from Botox should have fully resolved and other issues must be explored - for example any other product that may have been injected, allergic reaction, lymphatic drainage issues from the upper and lower blepharoplasty, etc.  I would work with your surgeon and an ocuplastic surgeon to determine what is causing this swelling.  

I recommend following up with your surgeon. At 4.5 months, this is unlikely due to the Botox. Hope this helps. 

Thank you for your question and for sharing your photographs loesha. I understand your concern. Botox is a purified protein used to address wrinkles associated with facial expression. When injected into the skin Botox will relax the muscles and smoothen out the overlying wrinkles. The most common areas of treatment are in the upper face. These include the horizontal lines seen on the upper forehead when one raises the brows, the vertical lines seen between the brows when one frowns (frown lines), and the crow's feet seen around the eyes when one smiles.It is difficult to make an assessment without a formal exam in the office where I can view the skin in multiple angles and observe wrinkles formed with facial expression. However, I hope the information provided here is useful.If I had a patient with such swelling, I would say it is likely secondary to an allergy and I would recommend consulting with an allergist. Swelling after a Botox treatment usually lasts for hours to a few days at most. And the full effects of Botox go away after three to four months.With any injection, there are risks such as pain, bleeding, bruising, redness, swelling, tenderness, and infection. We take special precautions to minimize these risks such as using a painless technique. We also treat bruises with a laser as early as the next day. Bruises usually resolve within two weeks if untreated. After a laser treatment bruises usually resolve in 1-3 days, but may still take two weeks for full resolution. In addition to these risks, with Botox there is also a risk that the product spreads or diffuses to nearby structures. Spread to nearby muscles can lead to side effects such as the temporary appearance of droopy eyelids or a temporary asymmetric smile.After a Botox treatment, I recommend that my patients avoid heat exposure, alcohol consumption, and strenuous exercise for 24 hours and not lie down flat for four hours. This is because all of these activities may possibly lead to the movement of the product and consequent side effects such as droopy eyelids as described above. Although there have been no definitive studies shown that these actually occur and some physicians do not provide such aftercare instructions, in the absence of data I err on the side of caution and recommend that my patients avoid such activities.Please consult with a doctor for specific recommendations. Good luck!

Thanks for your question and I'm sorry to see you are having this issue.  It's not immediately clear to me why you've got swelling but it is almost certainly not the Botox.  Even if Botox was the cause of the swelling initially- it's completely gone from your system in 3 months so persistent swelling like this is almost certainly something else.  It's hard to tell from your pictures brought in some your face looks red in addition to being swollen.  With the fact you clear completely on prednisone, I wonder if you haven't developed an allergy to something you are using on your skin.  A board-certified dermatologist should be able to help you with this.  Good luck.

At 4.5 months after your last Botox treatment, it is unlikely that the swelling is related to the Botox as the Botox should have worn off. I would followup with your injector and surgeon to discuss what maybe causing your swelling but I do not believe it is the Botox. 

I don't think this is a Botox problem unless fake Botox was used. I would guess this is more related to the surgery. I don't know if there were any implants, fillers placed during or prior to surgery. Consider hyaluronidase if there were fillers placed. 

I’m so sorry you had this experience. It is so unusual and unlikely for Botox to have an effect such as yours. I would be more apt to look into what possible effect could have happened with the bleph rather than Botox. I would also venture to guess that you have looked into and eliminated the possibility of any other culprit, from cosmetic to food to chemical that could be causing an allergic reaction. I wish you speedy resolution to your dilemma. Best of luck, Dr. Keyvani