Could this indentation in my head be from Botox? Help! (Photo)

Question

Indentation in head after years of Botox. Hi! A nervous wreck last year I noticed a slight indentation in my forehead near my scalp. Went to numerous drs, all told me it was nothing to be concerned with. A year later, I noticed after I allowed my Botox to fully wear off, that it is worse. Deeper. I can feel it and see it. I’m panicking and extremely self conscience of this. I have gotten myself into. So, more drs. Two different dermatologist/rhuem they say it’s nothing. So scared!

Nelson Lee Novick, MD · Answer

First, please don't panic. Botox, which I have been injecting for cosmetic reasons since 1991, is an excellent treatment for treating upper face dynamic wrinkles, such forehead worry lines. However, in some people repetitive use, there can be some muscle atrophy--especially if high concentrations and/or amounts have been used over an extended period time on a particular muscle. This may account for the subtle indentation evident in the photos. If this is indeed so, then the skillful use of an appropriate HA filler, properly injected, can elevate and smooth the indentation. Subcision may be used in addition or instead for a more permanent solution to this type of problem. So, you would be wise to consult with an experienced, board certified cosmetic dermatologist and, again, no need to panic. Best of luck.

Anil R. Shah, MD · Answer

Hello! My name is Jessica, I am a physician assistant, and one of the providers at Aesthetic Skin. This is a great question. I highly recommend scheduling an in-person consultation in order to better assess your areas of concern and discuss an appropriate treatment plan to help achieve your aesthetic goals. Our office phone number is: (312) 944-0117. I hope this helps and best of luck!

Glenn Murray, MBBS · Answer

Hello
I am sorry that you are experiencing this.  There may be several influencing factors at play here.
The most common one would be with prolonged use of Botox we do thin the muscle and in conjunction with the aging process and fat pad depletion in the forehead you may start to see some bony prominence appear. 
Some fine filler in this area may assist with softening the indentation.  I would caution you to find an experience injector as this is a high risk area.
Good luck.

Camille Cash, MD · Answer

An in person consultation is needed but it does not appear that the small indentation shown in the photos is worrisome.  It is difficult to say if it is related to Botox use.  It may be muscle atrophy, or could be natural changes from aging.  Regardless it does not appear medically concerning.

Could this indentation in my head be from Botox? Help! (Photo)

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