Why do I have wrinkles in my cheeks after Botox and Juvederm Voluma? (photo)

Question

Tomorrow will be one week since I first had Botox injected in my forehead, crows feet and 11’s along with Juvederm Voluma in my cheeks. I bow have wrinkles in my cheeks when I smile! It looks horrible, my right side has a deep indent and that cheek is also still a little tender. Will this go away? Do I still need to give it time to fill out?

Jason Emer, MD · Answer

It takes 1-2 weeks for final results with fillers and Botox. If you're unhappy with your results, venus legacy treatments can soften Botox results and you can have the fillers reversed with hyaluronidase. See an expert. Best, Dr. Emer

Nelson Castillo, MD · Answer

Thank you for sharing your question and photographs.  I am sorry to hear of your difficulties after filler placement but rest assured these symptoms should improve over the next 10 days.  It often takes up to 2 weeks for fillers to soften and the tissues to appear more natural.  In the meantime try reducing residual swelling by elevating your head at night with a couple of extra pillows behind your back.  You may want to also consider using Arnica Montana and bromelain as supplements.  I would look at your photographs from before treatment to identify how significant of radial smile lines you had present beforehand. Hang in there!

Vu Ho, MD · Answer

Since you are only 1 week out it is hard to say if you are looking at the full effects of the botox. Your physician should have explained that botox can take up to 2 wks before results are visible. I would speak to your physician about your concerns and follow up in 1 wk if you are still worried about the wrinkles.Best of luck!

Francis Johns, MD · Answer

Thank you for your question.I would give it a little more time, Botox can take up to 2 full weeks before it kicks in completely. You may also have some swelling from the filler injections. The products are maintenance treatments, so they are not permanent. Botox lasts around 3-4 months, Voluma can last 6-9 months depending on how fast your body metabolizes them.

Nicholas Gentry, MD · Answer

I would recommend another week of waiting. I would look closely at your before photos to see what was there before. Sometimes when we have fillers, botox or other changes, we notice different perspectives of our own face. If the line was not there and persists another week, then I would recommend more filler into the area to smooth it out. Pretty easily addressed typically.

Marek Kacki, MD · Answer

First, you should look at your recent photos before filler injection to make sure the lines were not there. Although there is still some swelling following injection you photograph appears to show the effect of 2 factors : 1. the deep facial compartments were not fully addressed; they are in very near proximity to each other and injection should result in a smooth transition. 2. if the Botox in crow's feet "freezes" the muscle, which is never necessary, than the soft tissue of the cheek is blocked from full upward movement during smile and meeting motionless tissue pushes it creating lines. You will be able to assess this after the swelling resolves. If it still causes the same problem and the lines are fully related to the injections than it can be mostly corrected with adding filler to the missed area. Of course, the filler could also be dissolved with hyaluronidase. Under those conditions I would expect the correction to be at no cost to you since it was not caused by you or the filler. Good luck!

Michelle Ellern, DO · Answer

Please wait another week or so for any swelling and bruising to resolve prior to attempting any correction.  Likely the issues with resolve with some settling of the filler. If you are still unhappy filler can always be removed and botox wears off over time. Good luck with your recovery.

Elisabeth Dancey, BM, BCAM · Answer

Give it a bit more time. The fact that the cheek filler is still tender suggests to me that it is still settling down and may be a bit swollen. Equally the botox might not have worked to its full capacity. After two weeks you should be able to see the true result. It is possible that the botox in the eye area might have been a  bit too effective and that you now have a single crease where the smile lifts the cheeks. If this is the case then next time have a little less botox in the eye area. You may have to put up with a few more crows feet but it will look far more natural.

Leonard Grossman, MD · Answer

Before anything else, I would have a look at your own photographs when you're smiling prior to the treatment. If the line was not there prior to the treatment and many people are not aware of it, I would speak to your physician, but still give it approximately 1 more weeks time. Good luck from New York City

Camille Cash, MD · Answer

I recommend waiting two weeks for your final results.  You still may have some residual swelling.  You can gently massage the cheek to help smooth this area.  If you still have concerns at two weeks I recommend returning to your injector for an evaluation.

Why do I have wrinkles in my cheeks after Botox and Juvederm Voluma? (photo)

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