Botox injection site on chin has swelled like a capsule is implanted. It's been 3 days. Will it go away? (photos)

Thank you for your question. I understand it’s been about three days since you had Botox injected into your chin, and you describe that you have some swelling on your chin in the shape of fish capsules. You consulted your doctor about this and they recommended additional Botox. At this point, you’re wondering whether the swelling will go away or not.Before anything, let me give you a bit about my background.I’m a Board-certified cosmetic surgeon and Fellowship-trained oculoplastic and reconstructive surgeon. Oculoplastic surgeons were actually one of the first doctors to use Botox before it became popular, as it was initially used as a drug for medical conditions such as benign essential blepharospasm and hemifacial spasm. In my practice, I have been using this drug for patients since 1993.Regarding your case, I think it does require more physical examination to truly understand what’s going on, but in the absence of that, I speculate there may be some fluid under the skin related to the application of the material and the volume of fluid. I noticed that there is the presence of some dimpling of the chin, which I suspect was the reason for Botox treatment. To address dimpling of the chin, Botox is often injected into the mentalis muscle. It is possible when this was done the injection was placed in an area with loose skin, and a certain amount of the fluid went into the muscle, while another volume of the fluid became elevated and remained in the superficial area of the chin. The ongoing effect of the Botox may also be partially responsible for this odd shape.It’s important to understand that the butolinum toxin found in Botox, Dysport, Xeomin and the like all come in powder form. The number of units per volume of fluid is calculated and then mixed together, depending on the physician’s preferred method. In my practice, I generally try to mix in as little fluid as possible, because over time I realized even though it is easier to calculate a larger volume, the patients would come out of the treatment with some swelling. So I concentrate the units per volume as much as possible, so can place the material into the muscle and with as little fluid around as possible.I think it may be beneficial for you to consider waiting it out to allow the fluid to become absorbed. You can even massage the area from time to time to help with this, and sometimes doing this leads to a resolution. However, if the fluid does not become absorbed, needle aspiration may be needed to get rid of it. Given that it has only been three days, it is probably best to wait it out and just maintain communication with your doctor for ongoing guidance.So I hope that was helpful and I wish you the best of luck!This personalized video answer to your question is posted on RealSelf and on YouTube. To provide you with a personal and expert response, we use the image(s) you submitted on RealSelf in the video, but with respect to your privacy, we only show the body feature in question so you are not personally identifiable. If you prefer not to have your video question visible on YouTube, please contact us.

This is very strange indeed. 3cc or 3mL is a large volume to inject into the mentalis muscle. Alternatively, if you were treated with only 3 units that is a very low dose for the amount of muscle activity you have there. It's hard to give you any specific advice without knowing more. Clearly your results have been suboptimal. If you trust your injector, have them try to refine this. If not, get a copy of your injection records (# of units, where injected) and seek a second opinion. I hope this information is helpful for you.Stephen Weber MD, FACSDenver Facial Plastic Surgeon

Hello,This looks like dimpling and muscles causing distortion with facial movement moreso than swelling. If 3 units were injected, then you should see these effects fade relatively quickly, within 2-4 months. I recommend allowing this to resolve on it's own rather than injecting more.All the best