Botox side effects - why is this happening and how can I correct it? (Photo)

Thank you for sharing your concern and photo it’s very helpful. What you’re noticing is actually a fairly common occurrence with Botox. When we treat the crow’s feet area, sometimes the untreated muscles just below or nearby can become more active, creating a new fold or line under the eye when you smile. It’s not harmful, but it can feel frustrating, especially if it looks more noticeable on one side than the other.

This effect can usually be corrected by a very small, carefully placed adjustment with Botox in the area under the eye, or sometimes by balancing the treatment on both sides. In other cases, a touch of dermal filler or skin-strengthening treatments like laser or microneedling can help soften that line further.

The good news is that this isn’t permanent it can be improved, and your treatment plan can be adjusted next time to prevent it from happening again.

Is the line there only after Botox - and it resolves as the Botox wears off? If so, then it has do with the way the facial muscles are being pulled (or not pulled as the case may be) while relaxed with Botox. There may be ways to adjust the injection sites if it is directly attributable to the botox

Hi!
This is a great question! It seems as though you may have something called "malar edema." Normally, our muscles contract and push lymphatic fluid and blood throughout our body. When the eye muscle underneath your eyes moves, it is also pushing out excess fluid normally. However, when Botox is injected either too much around the eye, it may cause the muscle to move much less, and cause a buildup of lymphatic fluid underneath your eyes. One thing you may be able to do to help drain excess fluid is to do some gentle facial massaging at home. This should help the line underneath the eye, and as the Botox wears off, this issue should be eliminated completely!
As always, an in-person consultation is required for definitive answers.
Best,Eleni Sgantzos, PA-C