Zygomaticus major muscle hit for treatment of crows feet with 4 units of Botox. What should I do? (Photo)

Question

I was my first time having botox treatment. It has caused a cheek drop and a hollowness under the eye. It has also created dark under eye due to the skin being pulled. I am 3.5 month post injection. I feel like a stroke victim. How much longer will this last? Is there anything I can do to help the process? Is it just a small part of the Zygomaticus major muscle that has been effected? Will exercise help? Massage?

Eric M. Joseph, MD · Answer

If your zygomaticus muscle was affected, you would have a severely crooked smile. Your photo in repose does not demonstrate the cheek drop and hollowness you're referring to. Consider re-asking your query with better photos. Thank you. Dr Joseph

Jason Emer, MD · Answer

Botox results resolve in 3-4 months. In the mean time, venus legacy treatments can soften results. See an expert. Best, Dr. Emer

Kenneth D. Steinsapir, MD · Answer

It is essential to understand that the emotional impact caused by this misapplication of botox are profound.  It can cause clinical depression and dysphoria. It is improbably that your symptoms will persist much after 4 months.  There are no specific exercises to help this.  Obviously, find a new botox injector if you elect to have service in the future.

Harold J. Kaplan, MD · Answer

Hello,This is a very frustrating and disappointing outcome to say the least.  Unfortunately, exercise and massage will not help - wouldn't hurt, but won't help as only time allows the muscle to "wake up."  In the meantime, using filler under the eye and to help support the right cheek may be a nice option to help camouflage the negative side effects.  The below link demonstrates the use of filler to shape and lift the cheek and under eye area.

Peter J. Jenkin, MD, FAAD · Answer

It's hard to see from the picture what if any abnormality exists.  A picture in animation would help.  Your lips look symmetrical so not sure which muscle may be the issue.  In any case, no matter what went wrong, you'll be back to normal very shortly-the unwanted effects and beneficial effects always wear off in 3-4 months.  Best.

Julie Edween, DO · Answer

dermo10,From the photos it seems highly unlikely that your your zygomaticus muscle was affected.  Botox on average lasts about 3-4 months.  There isn't much else you can do to speed up the process except for being patient and allowing your muscles to return to baseline.  Best of luck!Dr. Edween

Shaun Patel, MD · Answer

Sorry to hear about your experience. The Botox can take 3-4 months to wear off. I suspect you will see improvement shortly. Just give it a little more time.

Melvin Elson, MD · Answer

There is nothing that can be done to make this better any faster but at this point you should not have much longer to wait for this to go away

Vicki J. Levine, MD · Answer

Botox usually lasts 6 months.Have you noticed any improvement at all?I do not think anything besides time will help,if that muscle was hit

Zygomaticus major muscle hit for treatment of crows feet with 4 units of Botox. What should I do? (Photo)

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