Does Botox cause cheek ptosis and volume loss?

Thank you for your question. Botox in and of itself does not cause volume loss and the cheeks  when injected with proper technique in the crows feet region. If, however, Botox migrated into the smile muscles, it can weaken those muscles and cause the cheek to descend and give a more hollow appearance. Likewise, if the Botox also went into the temple muscles, then the temples muscles can also appear thinner and look more hollow as well. I would recommend that you go to a qualified injector if you decide to pursue this again.

botox has not been shown to cause volume loss.  repetative botox can atrophy muscle, but that is well known and a reason to use botox.  Best, Dr. Emer.

Thank you for sharing your question. Yes, if Botox migrates after the injection (sometimes through a tissue plane) or is injected in the wrong location, the cheek could fall. It would appear to be loss of volume, but is actually just a flaccid muscle. The problem should resolve within 4 months. Make sure you have only an experienced injector perform procedures on your face. Good luck. 

Dear whatisbeauty:So sorry for your disappointing results!The use of Botox and similar injectable muscle relaxers are art and science. The molecule is the same, the dilution and injection sites will be different. Injection techniques and the understanding of the anatomy and muscle balancing is the art behind the talent and skill of the injector. There is a small diffusion of any substance injected into the skin and other tissues. This is to be taken into consideration by the injector. The skin is tethered to the underlying fat and muscles by many fibrils and if the muscle is taught, it will "firm up the skin". If the muscle is relaxed, so will the overlying skin sag with gravity. Nuances in injection technique are not to inject deep near the inferior and outer lateral orbital rim as the muscle balance of the cheek will relax and displacement of the fat or volume loss may appear. I would suggest obtaining a second opinion from a talented and skillful Board Certified Plastic Surgeon who understands the art and science of injectables prior to laying fault to one of the most used, safe and efficacious drugs benefiting patients in the world. I hope you will have a better result next time. All the best and Happy Holidays!

Thank you for your interesting question. Botox/Dysport do not cause volume loss. But indeed if the injection is lower than should be at the crow's feet then it may weaken the cheek elevators and thus cause some downward shift of the cheek which may give the illusion of volume loss. AS ALWAYS SEE AN EXPERIENCED INJECTOR, PREFERABLE A FACIAL PLASTIC, OCULOPLASTIC OR PLASTIC SURGEON

Cosmetic doses of Botox in the Crow's feet area will not cause volume loss in the cheek or temple. If the Botox is placed too deeply or too low or too medial it can cause the cheek to drop or the smile to be asymmetric. Thankfully, this effect will be temporary. Unfortunately, it sounds like you've had a bad experience and don't trust the advice of your injector. I think it would be helpful for you to seek a second opinion and have someone evaluate your results and give you specific advice about how to proceed. I hope this information is helpful for you.Stephen Weber MD, FACSDenver Facial Plastic Surgeon

Quite simply Botox does not cause volume loss. In the crows feet lower areas it May migrate to affect the muscles that hold up the angles of the mouth. Therefore I would not use Dysport for you because it tends to spread more and I would use a more highly concentrated form of Botox and keep it higher in the crows feet area. 

I personally have never seen any volume loss or even heard discussion of volume loss related to botulinum toxin injection. It is possible that you could note some wrinkling of your lower eyelids from injection of the crow's feet but that is all.I'd recommend that you meet with other surgeons to get 2nd opinions since many people who benefit from Botox also benefit from injection of fillers.