New Wrinkles After Botox - Are They Permanent?

I'm only 22 and I had Botox a little over a week ago to treat/prevent crow's feet. They are pretty much gone now but my lower eyelid and under my eye area has gotten more wrinkled! I read it may be that these muscles are over compensating for the paralyzed ones. If that's the case, will they smoothen out after the Botox has worn off, or will the muscle actually grow and remain this way? Please help!

Doctor Answers 19

Overactive muscle function should stop when Botox wears off

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Why on earth would you do Botox at age 22? Cosmetic medicine has its consequences, as you now know. Sometimes, there is compensatory recruitment of untreated muscles to protect your eyes from too much light. Fortunately, the effects of Botox last only about 3 months. Your overactive muscle function should stop at that time. Please, do other things to prevent your wrinkles, such as moisturizing, sunblocking, wearing sunglasses and or a hat to shade your skin and eyes. You are far too young to start using Botox.

Temporary wrinkles

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The orbicularis muscle surrounds the eye. Botrox relaxes just the outer fibers, so the other fibers are not affected.

If a patient "tests" their Botox by smiling or "squinching", they may see more activity in fibers that weren't injected.

This should be a very temporary effect.

If it isn't temporary, and that is just the way your eye reacts to the new "balancing act " the muscles are performing, you can always wait for the 3 months and the Botox should go away completely.

22 seems very young to receive Botox injections. While I have no doubt your clinical situation warranted it, I don't usually advise my patients to get Botox for "preventative" reasons; rather only when a problem is actually there.

Brent Moelleken, MD
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 195 reviews

Compensatory wrinkles should resolve

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It is most likely that these lower eyelid wrinkles will resolve once the Botox has ceased to work. This is is relatively short amount of time.

However, if you continue to recieve the Botox, it is possible that you will develop fixed wrinkles.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 86 reviews

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Botox is not permanent

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No, these wrinkles that started to show after your Botox injection to the Crow's Feet are most likely due to compensation of the orbicularis muscle of the lower eyelid.  The Botox can't create permanent change after a single injection, nor can it create new wrinkles even though it does look that way at times.

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.7 out of 5 stars 28 reviews

Botox wrinkles are not permanent

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I agree with the other physicians that the best thing about Botox is that the results are very temporary. Your research may be correct--that your muscles are overcompensating for the paralyzed ones. I always like to see my patients back for a status post visit about a week after their procedure. I'd suggest making an appointment with your treating physician to speak with him about your concerns. Communication is always the most important thing when choosing a physician!

Stephen A. Goldstein, MD
Englewood Plastic Surgeon

BOTOX around the eyes

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It does sound like your lower eyelid muscles are "over-compensating" for the paralyzed obicularis muscle in the crows feet area. As a Board Certified Surgeon, I feel it is important to see our patients back in the office one to two weeks after their Botox treatment. This allows us to evaluate the effectiveness of the Botox.

Some patients benefit from additional low dose botox injections to correct muscle hyperactivity in other areas. Since your Botox will probably last 3 to 4 months, these notes help us determine what changes need to be made for your next treatment.

Daniel Reichner, MD
Newport Beach Plastic Surgeon
4.9 out of 5 stars 51 reviews

These wrinkles will not be permanent in your case

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Thank you for your question.

Botox is temporary, lasting only 3-4 months for almost everyone, with some exceptions. In your case, you've noticed extra wrinkles because of some overcompensating as the muscles causing your crow's feet are relaxed. As those same muscles regain their usage, your temporary "new" wrinkles should diminish.

Without knowing the details of your injection, and as you are young and you have begun to use Botox preventively, it may be wise to use low doses in a fewer number of places around the eyes, and evaluate those effects.

Theoretically, you should be able to acheive the look you want, the preventative effect you desire, and avoid future unwanted "newer" wrinkles. Hope that helps!

Don Mehrabi, MD
Beverly Hills Dermatologist

Lower eyelid wrinkles should return to normal

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I don't think you need to worry about the creation of permanent wrinkles of the lower eyelids as a result of your botox injections to the crows feet. This should resolve with time as the Botox wears off.

You might consider having just a couple of units injected to the lower eyelid region to soften those wrinkles.

Good luck.

Bryan K. Chen, MD
San Diego Dermatologist

Botox wrinkles should get better

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It is difficult to know whether you actually have more wrinkles under your eyes from muscle compensation or whether you think it looks like more wrinkle now that the sides of your eyes are smooth. Either way as the Botox wears off in the next 3 months, this should get better. Don't worry.

Kari L. Colen, MD
New York Plastic Surgeon
4.5 out of 5 stars 8 reviews

The nice thing about Botox is that it is not permanent.

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Botox can give patients a wonderful result by weakening or paralyzing muscles that create furrows or wrinkles.  On occasion, patients may notice something that they do not like following Botox treatments.  The effects of Botox generally last 3-4 months and then wear off.

Sanjay Grover, MD
Orange County Plastic Surgeon
5.0 out of 5 stars 245 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.