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.