Is volume loss after Botox caused by immobilized muscles or the fat being destroyed?

It is known and discussed with patients that botox can have effect around the area of injection and that botox paralzies the musles to the point they can thin or atrophy.  This was seen with many celebrities early on when we used to use much higher doses of botox (see nicole kidman).  but the chance of this happeneing more recently is less, due to less doses used.  I suggest you see an expert injector.  Best, Dr. Emer.

Thank you for your question and I am sorry to hear that your Botox effects were not what you anticipated.  Botox is a temporary compound that prevents your body's nerves from allowing muscles to contract.  With enough treatments these muscles can atrophy as a result of not being used (similar to not going to the gym, your muscles will shrink).  Once Botox wears off, these muscles will return to their original shape/size.  What sounds like may have happened is that your Botox migrated too far and affected unintended muscles.  Unfortunately this may persist for upwards of three months but should not leave you with any permanent effects.  Hope that this helps. 

You could have volume loss from Botox but I think the more important consideration is that you do not seem to be pleased with what Botox does... the good news is that it will wear off and you will be back to where you were in a period of several months. I would also advise you to discuss your concerns with the practitioner who treated you and get their input. Hope this helps