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.

Many thanks for your question. I would need to see before and after photos and see how much Botox has been injected, and in which sites, to give you an accurate answer.
However if Botox is injected too close to the brow in the forehead then it can cause the brow to drop, and if you have early signs of facial descent this can be exacerbated in some patients by Botox injected in certain parts of the face.
Either the sites of Botox injection need to be more carefully considered in relation to the changes in your face with age, or you may benefit from an endoscopic browlift and more minimal facelift procedure, such as a short scar facelift with SMAS plication, to correct the early signs of ageing.
A full examination in clinic would be needed to give you a more exact answer.
Good luck with your treatment.

I think it is important to understand that if you have loose hanging skin then botox will not make that go away.If you pull back on the skin and that gives you more the look you desire then maybe it is time to consider a lift.

Botox has some role but not all role. From your description of your problem it seems like that facelift time has come.

You would have to be seen in person. I can only guess that perhaps your brow is dropping and hooding your upper lids. This might suggest you might need forehead rejuvenation.

At age 41, is rather doubtful that  you will need a facelift procedure.  A full set of facial photographs required to make a determination about  being a candidate for surgical facelift procedure. The goal of Botox is to paralyze the super-dynamic muscles of the face/ forehead that create wrinkles.  When placed in the forehead, it can cause a droop of the eyebrows due to the paralysis of the elevator muscles of the eyebrows.  Your muscles have not moved lower. The goal of the facelift is to tighten loose facial and neck skin, tightened loose neck muscles, remove fatty deposits in the neck, and lift the jowls. For many examples of  what a facelift can accomplish, please see the link and the video below

Hello there! Thanks for your question. It most definitely sounds like your not having a normal response to Botox treatment. Botox should leave you looking refreshed with far fewer wrinkles. In the face there are muscles that elevate and depress. Selectively choosing which muscles to relax is crucial. Often times by injecting the muscles that depress the eyebrows my patients can experience an actual living of the brows without surgery. Another great non surgical option is great skin care to include Retin A which can reverse some early aging.
Now all that being said, there does come a time where Skin laxity becomes excessive and lifting of the face and or brows is indicated. In most situations this can be done with the aid of laser resurfacing to further eliminate  wrinkles, tighten the skin and stimulate collagen production! I wish you the best in pursuing your care!
Dr G

My feeling is that there are too many possibilities to give you an accurate answer through the Internet.  This may simply relate to aging or something more obscure and less likely such as the appearance of myasthenia.  I doubt the latter but discontinuing the Botox injections for six months will better enable proper assessment.  A browlift may prove to be beneficial but at age 41 I think a facelift would be somewhat aggressive and early.  An exam however would be very helpful.  Best wishes,
Jon A Perlman M.D., FACSDiplomate, American Board of Plastic SurgeryMember, American Society for Aesthetic Plastic Surgery (ASAPS)Beverly Hills, California