Botox around eyes: now got a deep indentation in my cheek when I smile, how can this be corrected? (Photos)

Question

Had botox around my eyes and have got worse wrinkles under my eye and an indentation in my cheek on the right side. Any way i can fix this? And any ideas why it has happened? Asked question earlier but could not manage to upload photos... so asking again with pictures included as i am desperate to Get this fixed. Lady who performed the botox said i need to use filler.. but i am very hesitant to do so. And feel botox actually aged me.

Carlos L. Wolf, MD · Answer

Botox is a wonderful drug when used properly. Botox is not Botox when it is injected by somebody who is inexperienced. It appears that you might have had too much Botox around your crows feet. This will give you an indentation when your facial muscles are pulling your cheeks up but you have no movement around the eyes. This will resolve on its own. The next time you might ask your doctor to put less around the eyes.

Christopher R. Macdonald, FRCS(Plast) · Answer

Thank you for the question and photos.
Unfortunately, this seems to be a result of either the BOTOX being injected too low or the dose being too high. This will disappear after 3-4 months and so I would suggest that you dont fill this hole with filler at all but wait it out (unless you also want fillers for another reason!).
Good luck!
Dr Chris Macdonald

Melvin Elson, MD · Answer

It is difficult to assess without seeing you but it sounds like the injections were too low and hit the zygomaticus which will cause this. if this is the case it simply has to wear off and may take a few months

Shaun Patel, MD · Answer

It's hard to give you an answer without evaluating you in person or seeing a set of photos. It is possible that the Botox around the eyes was extended too low into the cheeks causing a cheek "ptosis" (droopiness). If this is the case, you will likely need to wait for the Botox to wear off over the next 3-4 months.

Tom Jodlovich, MBBS, MPH (license suspended) · Answer

Thank you for your question.
What you are describing is usually referred to as "cheek shelving" - like a bookshelf, which generally results from a too high dose of a neuromodulator like Botox being injected too low in the crows feet region.
Unfortunately there is no additional treatment to offer that would expedite the effects of your Botox treatment. The effects are temporary and you should see increasing improvement of the effects over the next few months.
I suggest that you review the results with your injecting practitioner. Please consult with an experienced and highly trained practitioner to ensure your safety and for optimal results to be achieved.
Best wishes.

Botox around eyes: now got a deep indentation in my cheek when I smile, how can this be corrected? (Photos)

Answers (5)

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