Muscle atrophy from botox? (photo)

Question

ive been getting botox for the past year and a half as well as filler. I get botox for crows feet and for my under eyes. I have vertical indents on the right and left cheek when i smile. These were never there before. I am afraid these are happening from muscle degeneration from the botox. Could this be possible? My injector has injected radiesse and juvaderm into these spots, but they are back within a few weeks. My face has never had them before, and im terrified. Is there anything to fix this

Christopher J. Davidson, MD, FACS · Answer

Thank you for your question and photograph.  The indent around your eye is not likely muscle atrophy but rather the effect Botox that has relaxed the muscle or a depressed area that may need further filler injection for better contour.  Best to follow up with your injector.  Good luck.

Thomas Wright, MD · Answer

A mild atrophy can occur in the very muscles that are treated after years of Botox or other Neuromodulator.  Usually that would require 5 to 10 years of continuous, without breaks, relaxation of the treated muscles can cause atrophy. If atrophy occurs, which only occurs in a minority of patients, it is very mild.  The area where I see your " indents" is not under your orbicularis muscle, which is where Botox is injected. Rather your indent is on the lateral cheek where filler is often placed. Unfortunately Fillers may not move with contraction of muscles and so when you smile the indent occurs. I expect that letting the fillers dissipate over time will help or correct this issue.

Nelson Castillo, MD · Answer

Thank you for sharing your question.  It would be useful to see a photograph of you smiling from before the start of your use of botox and dermal fillers.  These lateral dents can be the result of irregular filler placement or may be a normal, anatomic variation of your cheeks.  See an ASPS board certified plastic surgeon in consultation, they can offer you the best treatment advice.

Monika Soni, MD · Answer

Thank you for your question. The dents around your eyes are not due to atrophy. This is due to Botox being injected to low. Next time your receive Botox injections I would not inject as low or in the under eye area. I recommend having a follow up with your injector to discuss your concerns. Best of Luck!

Hardik Soni, MD · Answer

Thank you for your question. The dents around your eyes are not due to atrophy. This is due to Botox being injected to low. Next time your receive Botox injections I would not inject as low or in the under eye area. I recommend having a follow up with your injector to discuss your concerns. Best of Luck!

Muscle atrophy from botox? (photo)

Answers (10)

Answer: The dents around your eyes are not due to atrophy.

Answer: The dents around your eyes are not due to atrophy.

Answer: Muscle atrophy from Botox

Answer: Muscle atrophy from Botox

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Muscle atrophy from botox? (photo)

Answers (10)

Answer: The dents around your eyes are not due to atrophy.

Answer: The dents around your eyes are not due to atrophy.

Answer: Muscle atrophy from Botox

Answer: Muscle atrophy from Botox

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Recommended reading

Everything you need to know about Botox

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