Major Increase in Nasolabial Folds After Botox for Crow's Feet

I agree with my colleagues on this one... I am very conservative in the crow's feet area, but might differ in that my dilution concentration is very low and therefore the volume I inject is very small. I target the muscles directly and do not see very much "spread" of Botox into nearby areas. 

I would not recommend any additional injections and would wait for the Botox to wear off at this point.

Dr. C

johnconnorsmd.com

There is very little that you can do at this point.  I would allow the Botox to wear off and refrain from further treatment in the future.  

It appears that you have deep paraconcentric smile folds. These were possible to make when yousmiled before botox in the crows feet but now you are noticing them more. It seems with such a big smile in your photograph that there is virtually  no creasing in the lower eyelid skin. The latter usually persists after Botox crows feet injections and sometimes is even more demonstrable from a compensatory reaction of non-treated muscles. If your muscles near the cheek bone were treated at the lowest crows foot area, then this might cause there to be less lower eyelid lines and less upward elevation of the corner of the lip when you smile. The other lateral cheek muscles may compensate and work harder to create the paraconcentric smile folds. It will go away in a few months or less but you shouldn't have any Botox injected into the cheek to weaken these lines because that will drop your lower face. If you don't smile too wide, your new smile lines probably won't be as evident. it

I would agree with Dr. Kavali's assessment. The Botox can diffuse beyond the area that it is injected and this may have happened in your case. The good news is that it will dissipate with time. The bad news is that it may take3-4 months. Occasionally I have seen the Botox "overshoot" for the first two weeks and then ease off.

Botox can make yourforehead smooth and your brows higher. If you have a lot of lines around your eyes and you get a lot of botox around the lateral orbit close to your cheek, it can make the cheeks lower. It will corrct itself in a month or two. It all depends on how low it was injected. You do have a nice result on your forehead. Maybe try to smile a bit less forcefull and if you want to improve the cheeks, volumize with a filler. It will partially correct your cheek droopiness if injected high and lateral on your cheek,over the zygoma bone area.

Placing large volumes of Botox in any one place and or rubbing may result in the Botox moving lower and causing an unwanted effect lower down. Without examining you it is hard to tell, but it appears the Botox placed to smooth your Crow's feet may have migrated lower and weakened some of the muscles lifting the cheek. as a result, some descent of the cheek may have taken place accentuating the nose to lip lines. This will resolve in a few months as the Botox effect goes away.

Dr. Peter Aldea

This is exactly why I don't inject low onto the cheek. I am aware that some injectors out there will inject Botox onto the cheek, in order to eliminate every wrinkle. I get great results injecting only the lateral crow's feet. It looks like the Botox diffused to the zygomaticus major muscle, which caused some midface descent. Unfortunately, there is no way to treat this; you just have to wait for it to resolve on its own.

I tend to be very conservative with botox in the crow's feet are for this reason.  Some of the muscles that pull your face up to smile (near the bottom outside corner of your eyes) could have been paralyzed from the botox so the wrinkles are bunching up lower where you see them on your cheeks.  Unfortunately you'll have to wait for it to wear off.

Dr. Cat Begovic M.D.

Botox and Dysport both have a zone of effectiveness and therefore some lateral spread away from the exact injection site.  Muscles that pull your cheeks up when you smile have been affected.  Make sure you inform your injector and you should use a lower dose in this area for your future injections.  I think you may find other techniques better for reducing crowe's feet lines (peels, fractionated laser treatments)

The glass is half full:  1) These 'watershed areas' will be the first to wear off.  2) Your Botox injections will be cheaper next time!!!!

Treating the crow's feet with Botox is a great way to loose some of those lines.  However, sometimes in "chasing" the lines along the cheek, you sometimes deactivate some of the muscle that allow you to smile and then the muscle works a bit differently causing different motion lines.  This will get better over time.