Mesobotox caused loss of cheekbones. Will I go back to my pre-Botox face soon? 5 weeks post.

Question

I had mesobotox and botox in masseter 5 weeks ago and now i loss my cheekbones on the right side of my face. I used to have plump cheeckbones which made me look young. Now i look older and with a flat face. Will i go back to my pre botox face soon? My doctor said she only injected on the skin, how come i loss volume on my cheekbones? Pls help

Maria Milone, MBBS · Answer

Hello
Your description of treatment is a little confusing as mesobotox is in the skin but masseter botox is deep and designed to shrink muscle volume in the lower jaw area 
If it was indeed mesobotox and in tbe skin only , it is possible that the dose was too high or some went a bit deep into your zygomatic muscles however this would most likely cause an altered smile so this seems unlikely.results from mesobotox wear off more quickly ie 1to 2 months
If you had masseters injected then the reduction in muscle bulk that this causes can give some hollowing of the cheeks which most people actually like however if you dont like it , it will take up 4 to 9 months to recover.

Monika Soni, MD · Answer

Thank you for your question! After a Botox treatment, I recommend that my patients avoid heat exposure, alcohol consumption, and strenuous exercise for 24 hours and not lie down flat for four hours. This is because all of these activities may possibly lead to the movement of the product and consequent side effects such as droopy eyelids. Although there have been no definitive studies shown that these actually occur and some physicians do not provide such aftercare instructions, in the absence of data I err on the side of caution and recommend that my patients avoid such activities. Best of luck!

Alex Eshaghian, MD, PhD · Answer

Thank you for your question and for sharing your photographs bikinibliss. I understand your concern. Botox is a purified protein used to address wrinkles associated with facial expression. When injected into the skin Botox will relax the muscles and smoothen out the overlying wrinkles. The most common areas of treatment are in the upper face. These include the horizontal lines seen on the upper forehead when one raises the brows, the vertical lines seen between the brows when one frowns (frown lines), and the crow's feet seen around the eyes when one smiles.It is difficult to make an assessment without knowing the dose used and the exact placement of the product. However, I hope the information provided here is useful.The pivotal studies used 24 units of Botox (12 units per side) to address the crow’s feet. These studies demonstrated that the peak results are seen 14 days after the treatment and most people enjoy their results for 3-4 months. At that point, a maintenance treatment is recommended. While some people start to see results as early as the next day, it can take two weeks for full results so patience is important. We have our patients return two weeks after their treatment to assess their results via photographs. At that time additional units may be added if necessary.Botox can be placed in the masseter muscle in the lower face to contour the lower face and address pain associated with TMJ. In this area 20-40 units of Botox are used per side. Depending on the reason for the enlargement of the muscle, permanent results may be achieved. For example, some people have a habit of grinding, clenching, or biting their teeth subconsciously. Often times this happens in their sleep when they are not aware of it. Botox placed in this muscle will relax the muscle and the grinding, clenching, and/or biting will decrease. This will reduce the size of the muscle. If the brain gets accustomed to this and the person stops grinding, clenching, or biting, then the muscle will not become enlarged or as enlarged again. However, if the habit starts again, the muscle will likely get larger.To determine if someone is a good candidate for this treatment it is necessary to look at a person’s lower face when biting and comparing it to when the person is not biting. If a bulge is seen on the outer portion of the jawline, then the person is likely a candidate. It can also be felt with the fingers when biting.Some people have a deficit under the eyes due to loss of or downward movement of the fat pad inthe tear trough area. In some cases, the muscle around the eyes serves to hold up the upper cheek fat pad. If this muscle is relaxed with Botox (as it is when addressing crow's feet), this volume deficit can be exaggerated. In these cases, restoring the lost volume with fillers such as Volbella or Vollure under the eyes or Voluma in the cheeks can correct the deficit.If I had a patient with the concern described here I would first want to know the dose and placement of the product. She would likely be a good candidate for the treatment with fillers described above.With any injection, there are risks such as pain, bleeding, bruising, redness, swelling, tenderness, and infection. We take special precautions to minimize these risks such as using a painless technique. We also treat bruises with a laser as early as the next day. Bruises usually resolve within two weeks if untreated. After a laser treatment bruises usually resolve in 1-3 days, but may still take two weeks for full resolution. In addition to these risks, with Botox there is also a risk that the product spreads or diffuses to nearby structures. Spread to nearby muscles can lead to side effects such as the temporary appearance of droopy eyelids or a temporary asymmetric smile.
  
After a Botox treatment, I recommend that my patients avoid heat exposure, alcohol consumption, and strenuous exercise for 24 hours and not lie down flat for four hours. This is because all of these activities may possibly lead to the movement of the product and consequent side effects such as droopy eyelids. Although there have been no definitive studies shown that these actually occur and some physicians do not provide such aftercare instructions, in the absence of data I err on the side of caution and recommend that my patients avoid such activities.
  
Please consult with a doctor for specific recommendations. Good luck!

Justin Harper, MD - Account Suspended · Answer

Hi bikinibliss,It would have been helpful if you had included the number of units injected. It's true that Botox can shrink the masseter but quantities used for MicroBotox won't. Botox will shrink your muscles and to be hones, you don't look older in the photos on the right (assuming that's the "after"). The effect of Botox will wear out in about 3 months and everything will likely look as it was prior to the injections. However, if you want more pronounced cheekbones, you will probably need hyaluronic fillers like Lyft or Voluma or a collagen inducing one like Sculptra.All the best, Justin Harper, M.D.

Mesobotox caused loss of cheekbones. Will I go back to my pre-Botox face soon? 5 weeks post.

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Answer: Mesobotox caused loss of cheekbones. Will I go back to my pre-Botox face soon?

Answer: Mesobotox caused loss of cheekbones. Will I go back to my pre-Botox face soon?

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Mesobotox caused loss of cheekbones. Will I go back to my pre-Botox face soon? 5 weeks post.

Answers (4)

Answer: Mesobotox caused loss of cheekbones. Will I go back to my pre-Botox face soon?

Answer: Mesobotox caused loss of cheekbones. Will I go back to my pre-Botox face soon?

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