Muscle atrophy from botox? (photo)

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.

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. 

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. 

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!

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!

Hi There Thank you for your excellent question and photograph.I think that the issue is nothing to worry about. In my practice I would stop for 6 months and then re do the botox using a different configuration which will solve the problem.Also be sure that it is injected intradermally and not too deep.Please don't worry it really is very straightforward.Kind Regards Dr Dinesh Maini 

I would not expect such changes in association with Botox treatment, especially over such a relatively short period of time (1.5 years). I would wonder more about the effects of the filler since those can resorb at different rates and may cause the asymmetry you describe. 

First we don't want you to upset by this.  If it is do to Botox injections then if you discontinue for a period of time it will return.  I don't think this is necessary ad I don't believe it represents muscular issue.  I would like to review your injection notes for filler and review previous photos to better understand how to develop a plan for you.

Dents around the eyes after Botox are not due to atrophy. They are due to the Botox being injected too low. Next time I got Botox, I would not inject as low or in the undereye area. 

Muscle atrophy happens in the procerus, corregator and frontalis muscles after long term usage ( these muscles are located above your eyes on your forehead area) .  It will not happen in the cheeks or areas it was not injected. You likely are experiencing  volume loss which happens in the normal aging process.