How Can Experienced Botox Injector Get It Wrong? Are There That Many Injection Techniques for Same Area?

Had Botox 8 wks ago. Used it 7yrs with PS, always loved results. Decided to try new Dr offering new patients $9 Botox. After researching, He was thought to be Best Botox injector in Utah, Runs Botox blog & been on local TV. I felt certain I could save $ & still get great results. NOT! Fastest Botox ever 42u under 5 min. Injections felt much different & Results - visible dents in forehead, deep dents around eyes, 11's still visible & eyebrow droop. Can I get botox to correct his Botox injections?

Doctor Answers 13

When botox doesn't turn out the way you want, there may be several reasons.

Botox works great around 9/10 times. Sometimes it lasts longer than the 3-4 month average, and sometimes it is shorter. 42 units almost never covers the forehead, glabellar frown area and sides of eyes.  The most common problem is not getting enough botox to do what you want it to. It should be at least 60 units for all those areas and $14-16/unit usually assures you are get real botox rather than cheap foreign stuff. When you don't do enough then areas don't get partially paralysized so there will be areas of "dents" which is just the border where the botox was injected and the muscles don't move much and where it wasn't injected so the muscles do move a lot. Getting more botox into these transitions should resolve the problem quite easily. Also if you've had alcohol, taken aspirin, advil etc.. within the last week, then you are going to bruise and it is nobodies fault but your own. ice the areas alot and take arnica to help with bruising and swelling. The technique that seems to look the most natural and smooth is that the doc injects many many small spots with the botox rather than only a few big ones. I hope this helps explain the variations that can happen . Sincerely,David Hansen,MD

Beverly Hills Dermatologic Surgeon
4.7 out of 5 stars 42 reviews

How Can Experienced Botox Injector Get It Wrong? Are There That Many Injection Techniques for Same Area?

It is always possible to have a complication even with an experienced Botox injector. However, it is unfortunate that you are disappointed with several aspects of the treatment. Botox should not cause any dents in the injected areas so I am not sure what happened with that aspect of the treatment. Additional Botox can be used to reduce the amount of movement that you still have. An eyelid droop, unfortunately, cannot be corrected with additional Botox but it is temporary. Iopidine drops can be prescribed to raise the drooping eyelid while the Botox wears off as long as you don't have any medical contraindications to the drops. It sounds like you would be best off returning to your injector that provided such great service to you for so many years.

Stephen Weber MD, FACS

Stephen Weber, MD, FACS
Denver Facial Plastic Surgeon
4.9 out of 5 stars 129 reviews

Botox injection problems

Every injector develops their own patterns and techniques based first on training, then experience with observing patient results. A good injector will have you make many specific facial expressions to identify the location of the muscles they are targeting. An understanding of facial anatomy is a must.  I would let the current treatment wear off a little before adding more toxin. 

Matheson A. Harris, MD
Salt Lake City Oculoplastic Surgeon
5.0 out of 5 stars 6 reviews

Botox injection techniques

While every injector is different in their individual method and Botox placement, there are generally followed guidelines for achieving the best results. If you weren't happy with the results from your new provider, small corrections can be made to right any asymmetry or areas of concern. Building a trust with your injector and communicating expectations is key. I wish you best of luck.   

George T. Boris, MD, FRCS, FACS
Los Angeles Facial Plastic Surgeon
3.7 out of 5 stars 18 reviews

How Can Experienced Botox Injector Get It Wrong? Are There That Many Injection Techniques for Same Area?

Yes, injection technique and training are probably the two biggest keys with Botox, besides the basics of diluting. It's hard to say why your new injector didn't get it right....other than the fact you had someone you loved for 7 years and decided to try someone else. A tiny injection into a different point, using a few different units here vs. there, all of these things matter and will change up your results. I don't know why the injections themselves would have felt different other than technique or site maybe? I would suggest you maybe return to your old injector that made you happy and see what he or she thinks can be done. Otherwise, time will be your best bet, and returning to the injector you already like!

F. Victor Rueckl, MD
Las Vegas Dermatologist
4.6 out of 5 stars 17 reviews

Cheap Botox...You Got What You Paid For

Hi Dmarie,   The simple answer to your question is that when it comes to your face, cheap is not better.  When practices advertise to attract patients at a low cost point, they need to treat a lot of patients to make up the cost of the material as well as the cost of advertising.  Hence the physician was rushing, got horrible results, and who knows whether you even got what you paid for (you may not have recieved the units that you were told).  So once again, when it comes to your face, most of the time you get what you pay for.  Good luck and be well.   Dr. P

Michael A. Persky, MD
Encino Facial Plastic Surgeon
4.8 out of 5 stars 36 reviews

Botox Injector

I am sorry to hear that you received a bad result from your last Botox injector.  Without seeing your photos, it is difficult to know if further Botox injections might correct some of the problems you've described.  While technique may vary somewhat among injectors, good knowledge of facial anatomy and an understanding of how Botox affects the facial muscles are crucial.  You absolutely should not have "dents" as a result of the injections.  I would recommend returning to the plastic surgeon you were pleased with.  Best of luck to you.

Mark Deutsch, MD
Atlanta Plastic Surgeon
5.0 out of 5 stars 32 reviews

Botox works great

Botox usually works great. In rare ocassiosns it can travel to other areas and you can have an unwanted effect.

It could be corrected by injecting other products but it is an individualized process.

Jhonny Salomon, MD
Miami Plastic Surgeon
4.3 out of 5 stars 45 reviews

Results from Botox on sale were bad. Don't always go for the cheapest price!

Sometimes, the only way for a practice to attract new clients is to put their Botox on sale.  Be warned, it doesn't always get you to the results you were expecting.  Just because someone is in the news or advertises a lot, does not mean they are good injectors.  Often, it just means they have a great marketing department.  Correcting bad Botox can be done in certain cases but not all.  It's unfortunate that this happened to you.  When you go in for a cosmetic procedure you expect to look better, not worse, after getting treated.  This is an all to familiar story that I see almost everyday.  It ends up costing even more than going to the regular priced physician, as well as more time, and frustration.  Best advice, go to someone you are comfortable with, your friends recommend, and has been doing it for years.  I've been injecting since 1994 and have previously taught other physicians how to inject.  Steve Weiner, MD, Destin, Florida.

Steven F. Weiner, MD
Panama City Facial Plastic Surgeon
4.7 out of 5 stars 41 reviews

How Can Experienced Injector Get it Wrong?

My advice is to wait until the Botox is fully worn off, (at least three months)  and then find a new injector.  Price is not always better.  Ask friends which plastic surgeon they use for their injections. 

Fred Hackney, MD (retired)
Dallas Plastic Surgeon
5.0 out of 5 stars 20 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.