Rare Botox-Juvederm Complication, or Unqualified Injectionist? (photo)

I had my very first experience with Juvederm and Botox. It did not go well. I ended up with Major Bruising under my eyes that lasted more than 2.5 weeks, an infected pustule under one eye and a large elongated bag under the other that needed Vitrace to dissolve. And then to top it off I ended up with Ptosis in both brows and eyelids and a facial droop in both cheeks that made my lips wrinkle and look puckered. The ptosis lasted almost 3.5 months far. What went wrong? Am I not a good candidate?

Doctor Answers 12

Bad injector

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Please understand that these are not commodity services.  If they were, it just would not matter who you went to.  However who you go to makes an amazing difference.  Look around in your community and only go to ethical practitioners with good reputations who know what they are doing.

Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 26 reviews

Good injections are possible in the hands of good injectors only

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this is technique dependent issue. Im not sure who did the injections for you but from the pics it seems like that was your problem. I would do my homework and inquire around in the area where u wish to get the procedure done and only go to Board certified dermatologist or a plastic surgeon for your injections. u might have to pay a little bit higher but at least u will have a better experience. 

Misbah Khan MD, FAAD, FACMS
New York Dermatologic Surgeon
4.9 out of 5 stars 32 reviews

Good injections require Good Injectors!

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I would not be able to comment on your candidacy for injections basd on photos alone, but it would seem you would be.  Typically, medical conditions, medicines that thin your blood and pregnancy make injections inappropriate.  I am very sorry tht you have had a bad experience thus far, but I can say is that I recommend you not give up on injections and find a qualified board certified physician to inject you. I also suggest you discuss in detail your most recent injection. Good luck--be safe! 

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Your injector matters

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I cannot make an assessment on your particular case but it is extremely important that you go to a physician to have them administer your injections.  Your facial anatomy is complicated.  Don't trust your skin to estheticians injecting.  Only providers who have had anatomy courses and learned on cadavers can really know and understand the anatomy of the face.

Angela Bowers, MD
Southlake Dermatologic Surgeon
5.0 out of 5 stars 1 review

Botox and fillers around the eyes should be done by experienced doctors

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Swelling of the lower eyelids can occur if the pump action of the lower eyelid muscle is compromised by Botox injections and the patient has a history of swelling, such as in the morning upon arising.  Fillers can be placed below or above the lower eyelid muscle.  Below the muscle creates less swelling and bruising but above the muscle can create lumps and bruising and more swelling. Regardless, both treatments are off label and you need to find an experienced physician to do such treatments.

Ronald Shelton, MD
Manhattan Dermatologic Surgeon
4.9 out of 5 stars 39 reviews

Injector specific

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I  ams orry that you have had so many issues. Most patients are extremely pleased with the results of fillers and botox, but it is has to be performed by a good injector.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Injector skill is critical

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Without knowing medical history, pre-injection appearance, injection technique (sites, volume of filler, units of Botox), etc.... it is not possible to accurately make any statements about your particular result.  Photos are only so helpful.  What I can say is that getting good results from a Botox or filler treatment is highly dependent on the skill of the injector.  This is not a time to look for the best bargain.  Make some inquiries and go to an experienced injector with a long track record of good results.

It is a rare patient who is not a reasonable candidate for this treatment, if it is done properly.


How to choose your physician injector

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Because this is an art as much as it is a science, it is especially important to remember that the experience and technique of the physician who injects you is the most critical part to your achieving a beautiful, natural result. Always ask about the experience of the injecting physician and make sure they have all of the "tools" to use, such as all of the various facial fillers (Sculptra, Radiesse, Perlane, Restylane, and Juvederm) that are approved for use in the United States. The effectiveness of your treatment depends on your physician’s ability to visualize the desired changes and to select and skillfully administer the best treatments alone or in combination. Since every face is different, the experience and technique of your physician injector is the most critical part to your achieving a beautiful, natural result. Always ask to see before and after pictures of patients they have personally injected. If possible, look for someone who is on the medical education faculty for one of the facial fillers. If they have been selected to train other physicians how to treat the aging face they are likely to be good, experienced injectors.

Mitchell Schwartz, MD
South Burlington Dermatologic Surgeon
4.4 out of 5 stars 13 reviews

Rare side effects

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I am so sorry that your first experience was not a good one but hope that you understand that you still can have a great experience with these products. The key is to have someone do this slowly and carefully, make sure that they know what you want and that they HAVE LOTS OF EXPERIENCE with this. This is not the time to shop for a bargain. 

Jo Herzog, MD
Birmingham Dermatologist
4.8 out of 5 stars 20 reviews

Complications vs bad injectors

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I would agree with the others posting on this site. It's hard to declare that you are or aren't a candidate based on photos alone and without knowing your medication history or anything going on with you that may complicate matters, but with all that being said, the most important thing with injections is to find a good, qualified injector. And that's not usually based on price! Shopping around for the cheapest deal, most often, gets you the least experienced injectors with sometimes questionable products even. Ptosis shouldn't and doesn't have to last for 3.5 months. There are eyedrops that help speed the resolution of this much faster. While swelling and bruising are normal with fillers, it seems yours lasted quite a bit longer, which can be from an inexperienced injector who uses poor techniques. Mostly I would say this: injectors should be board-certified physicians. We have the most experience and the most training, period. So next time, visit a plastic surgeon, dermatologist, or another physician who others recommend. Technique takes years of practice to perfect, and you shouldn't be someone's guinea pig.

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.