Botox in crows feet caused malar bags/festoons? (Photos)

Question

Received Botox injections in the crows feet region (10 units each side) for the first time. A couple weeks later malar bags/puffiness on the upper cheek appeared. I was told they would go away when the Botox wore off. It has been over a year and a half since the injections! They have not improved at all. Consulted numerous places and no one has answers, except for no way it was caused by the Botox. 30 years old, and seeking a non-invasive treatment to improve the appearance.

Nima Shemirani, MD · Answer

Hi @Helpful773817! Botox is unlikely to cause the development of festoons. Festoons are usually caused by dermal fillers. A non-surgical approach would be a RF microneedling treatment like Morpheus 8. Morpheus8 is a non-surgical treatment for full body skin resurfacing, skin tightening, and fat reduction of stubborn areas. It uses minimally invasive fractional radiofrequency energy (RF) to penetrate the skin deeper than other microneedling devices, triggering the skin’s natural healing response to promote skin tightening and lifting. Best of luck to you!

Jason Emer, MD · Answer

I would highly recommend getting a formal evaluation with and treatment from a board-certified cosmetic dermatologist and expert in facial sculpting. An experienced physician will be able to determine which technique will give you the result you're looking for. See an expert. Best, Dr. Emer

Jonathan Kulbersh, MD · Answer

Hello — thank you for your question and photos. Botox is unlikely to cause the development of festoons. This is a far more common consequence of poorly injected dermal fillers. If you’ve had fillers performed, you may want to consider having them dissolved. If you haven’t, it’s possible that your festoons aren’t connected to your Botox injections. There are steps you can take to minimize their appearance, including RF microneedling. I highly encourage you to schedule a consultation with a board-certified facial plastic surgeon to discuss your concerns and determine the appropriate treatment.

Camille Cash, MD · Answer

It would be unlikely that the Botox caused the formation of the festoons.  The condition is difficult to treat but one option is Morpheus8 treatments.  This combines microneedling with RF technology to remodel tissues, improving overall skin tone and texture.

Morlux Nurses - Norwalk - Account Suspended · Answer

Hello and thank you for your question. Botox usually temporarily immobilizes muscles in the area that were injected and is not likely to cause what looks like what you may call festoons. Those may usually be caused by dermal fillers when injected in the area. I am not able to determine if you had fillers at the same time as Botox by your question, but in the event that you did, perhaps getting the fillers dissolved may help the area.

Botox in crows feet caused malar bags/festoons? (Photos)

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Answer: Botox temporarily immobilizes muscles

Answer: Botox temporarily immobilizes muscles

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Botox in crows feet caused malar bags/festoons? (Photos)

Answers (5)

Answer: Looking for options

Answer: Looking for options

Answer: Botox temporarily immobilizes muscles

Answer: Botox temporarily immobilizes muscles

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Recommended reading

Everything you need to know about Botox

Our mission is to create a world where every investment in modern beauty is Worth It.