Is my face falling and is making my botox look weird bc all my muscles have moved lower? Am I going to need a facelift at 41?

Depending on the level of laxity, the effects of a facelift and/or a neck lift will certainly outlast the effects of non-surgical treatments. Non-surgical procedures can only temporary resolve the issue and require few to several attempts. It's best to begin by consulting with a surgeon in-person. During your #consultation, your skin texture and elasticity, as well as your underlying skin structure and your facial bone structure will be evaluated. Based on this evaluation, your board certified plastic surgeons will create a custom surgical plan, detailing specific techniques and recommendations to meet your goals. In doing so, he or she should be sure to have a full understanding of what results you expect. 
Patients who desire facial rejuvenation that is affordable, quick, and effective should consider the Lite-lift™. Like the Life-Style™ facelift, this is a modified facelift that can be performed in the office with a local anesthetic and improve signs of aging around the neck, jawbone and lower face. These procedures are not "Thread-lifts" or "String-lifts". We do not use the "barbed" sutures employed in these other lifting operations. The Lite-lift™ uses longer lasting techniques that are discussed below. Because the incisions are limited, there is less bruising, swelling and healing time for most patients. Many patients can be back to work in one to two weeks looking rested and more youthful. 
If you are not a candidate at the time of your #consultation, your board certified plastic surgeon can recommend alternatives to address your concern. Consulting with a board-certified plastic surgeon who specializes in neck and facial procedures is important to ensure you are receiving the best advice, care, and surgical experience possible.

Hello,
There are three factors contributing to the outcome: The injector (=technique used), the injection (=Botulinum toxin) and the injected (=you). Obviously you can't modify yourself, but you could try a different type of Botulinum toxin and try a different injection technique either by your usual doctor or by a colleague. If none of them makes a difference, then it is probably the way your body reacts.

Thank you for the question.  Botox does decrease the function of the muscles it is injected into.  This can result in "drooping" of the face depending on where it is injected.  It is possible you may benefit from surgical options or other non-surgical alternatives.  It would be best to be evaluated by a board certified plastic surgeon experienced in facial rejuvenation to explore your options.