Can Botox in forehead cause vertical lines down across eyelids and then cheeks? Noticed both since first Botox in June (Photo)

Botox  does not address wrinkles in the skin that are present at rest. It addresses dynamic lines, those that are increased with certain muscles movements or facial expressions. Fine lines and wrinkles are sign of aging, worsened by years of inadequate exposure to sun, inadequate skin care, hereditary factors, and worse of all, smoking. Occasionally, Botox unmaskes signs of aging that patients have prior to treatment. In those situations, the answer is rarely additional Botox, but rather, other methods of facial rejuvenation such as skin care, fillers, laser resurfacing, and/or face/brow/neck and/or eyelid surgery.

Thank you for sharing your question and photograph.  I do not feel that Botox caused these vertical lines and would advise a combination of skin care, dermal fillers, and chemical peels to improve the appearance of the wrinkles demonstrated in your photos.  Hope this helps.

As others have mentioned, sometimes using botox to treat one group of muscles can then cause another group of muscles to work harder - which can then cause a *different* set of wrinkles. 

Based on your photos, some of these lines appear to be a result of natural aging, as they are in areas where muscle action is less likely to be the cause. Not to worry: many treatments are available andwould best be determined once you are examined in person. Treatment can include a combination of additional botox, fillers (e.g. Juvaderm) and/or skin resurfacing (e.g. laser).  Whatever you do, please be sure to consult with an expert.

In Good Health, Dr. Cabin

Sometimes Botox can cause lines when compensatory muscles work. A touch up of Botox, lasers and microneedling/prp can help this. See an expert. Best, Dr. Emer

Sometimes Botox can cause compensatory use of other muscles. A touch up on the Botox can help. Sometimes fractional laser and ematrix can also build collagen in the area. 

Best, 

Dr. Karamanoukian

Los Angeles