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

Question

I have noticeable volume loss in my face after Botox. I had injections at top of frontalis, the 11's area and the crows feet, 10 weeks ago. It definitely drifted. I still feels reactive in tissues from the crows feet, downward to the zygomaticus, above my lip and on my chin. It is unexpected tingly paralyzing feeling that only began after Botox. When does the stop drifting? Is the volume loss due to paralysis of surrounding tissues or fat loss? Drs. need to warn of these negative effects

Jason Emer, MD · Answer

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.

Nelson Castillo, MD · Answer

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.

James D. Wethe, MD · Answer

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

Jesse E. Smith, MD, FACS · Answer

Luckily, volume loss after Botox is merely a temporary side effect of muscle atrophy.  If you chose to, you could stop the Botox, and within 3-6 months the volume would return; unfortunately, with the volume, the muscle movement and the lines would return as well.  One compromise is to decrease the units of Botox injected into the sites, this would retain some volume, while still decreasing the lines that may bother you.

T.G. Khan, DO, FACS · Answer

That's quite a way for Botox to spread. Are you sure this was brand name Botox from Allergan?  In some patients they can also have a psychosomatic effect after a treatment. I would wait it out until the effects completely wear off.  I would of course see your practioner as soon as possible so he or she can evaluate you.

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

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Answer: Volume loss after Botox

Answer: Volume loss after Botox

Answer: Botox migration

Answer: Botox migration

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

Answers (6)

Answer: Volume loss after Botox

Answer: Volume loss after Botox

Answer: Botox migration

Answer: Botox migration

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Recommended reading

Everything you need to know about Botox

Our mission is to create a world where every investment in modern beauty is Worth It.