Indents by Nose When Smiling after Botox (forehead and crows feet) and Restylane in Cheeks

Question

Hello, I had Botox in my forehead and crows feet and 1 syringe of Restylane in my cheeks to help with my nasolabial lines. Since these injections, I actually feel like I look older because new deep indents under my eyes have emerged following the procedure. The indents are more prominent when I smile. Also the cheek filler seems to have migrated to the apples of my cheeks and I look strange. For the botox, when I raise my eyebrows, I have an area of my forehead that protrudes like a shelf?

Glenn Lyle, MD · Answer

Hi, Your filler does appear to have migrated to the apples of your cheeks. This needs to be dissolved. Make sure they are injecting deep in this area to avoid migration. Botox question, did they treat the Glabella? (Area between the brows) if not, have them treat that and it should alleviate your shelf appearance.

Anna Avaliani, MD · Answer

Your photos ave very helpful1. Your botox didn't settle right or wasn't injected right. The shelf should not be there unless they skipped glabella and injected your forehead only because that was was bothering you. One needs to respect the dynamic movement of muscles to avoid results like this. This is unfortunate. If you now have Botox injected into the labella, it will make things feel heavy, so I suggest to wait it out,2. Filler in the cheek wasn't injected correctly either, causing those lumps to form, hence it needs to be dissolved.3.You can also wait 3 months until Botox wears off and decide if the lumps are still there and then dissolve it. Waiting is harder to do when your beautiful smile is affected but you don't want to create more issues .
Best of luck.Dr.Anna Avaliani, NYC
Hope this helps.

Milan Shah, MD · Answer

The appearance of indents by the nose when smiling after receiving Botox injections in the forehead and crow's feet areas, as well as Restylane injections in the cheeks, could potentially be due to various factors:1. Muscle Movement: Botox works by temporarily paralyzing or weakening targeted muscles to reduce wrinkles and fine lines. In some cases, when the muscles around the nose are weakened due to Botox injections in the forehead or crow's feet, it can alter the dynamics of facial movement, potentially causing changes in the appearance of nearby areas when smiling.2. Volume Redistribution: Restylane injections in the cheeks are meant to add volume and contour to the cheeks. However, the redistribution of facial volume caused by cheek filler injections can sometimes affect adjacent areas, leading to changes in the appearance of the skin around the nose when smiling.3. Individual Facial Anatomy: Everyone's facial anatomy is unique, and how the muscles and tissues respond to injectable treatments can vary from person to person. The appearance of indents by the nose when smiling may be influenced by the individual's specific facial anatomy and how their muscles and tissues interact with the injected substances.4. Technique and Placement: The technique and placement of both Botox and filler injections can significantly impact their outcomes. Improper injection techniques or placement may lead to unintended side effects or changes in facial appearance.If you're experiencing concerns about the appearance of indents by the nose when smiling after receiving Botox and Restylane injections, it's essential to discuss them with the healthcare professional who performed the injections. They can evaluate your concerns, assess the results, and recommend appropriate measures, which may include adjusting the treatment plan or providing additional guidance on post-treatment care. Additionally, it's crucial to give your body some time to adjust to the treatments, as it's not uncommon for minor issues to resolve on their own as the injected substances settle and the muscles adapt.

Indents by Nose When Smiling after Botox (forehead and crows feet) and Restylane in Cheeks

Answers (3)

Recommended reading

Everything you need to know about Restylane

Our mission is to create a world where every investment in modern beauty is Worth It.

Indents by Nose When Smiling after Botox (forehead and crows feet) and Restylane in Cheeks

Answers (3)

Browse related questions

Recommended reading

Everything you need to know about Restylane

Our mission is to create a world where every investment in modern beauty is Worth It.