Botox and Hourglass Deformity - Richland, WA

So after posting my question to the RealSelf doctors I was reassured by all the doctors who said it was really simple to fix the temple area with fillers or implants. In real life though, I haven't been able to find a plastic surgeon who does it in Washington State. I'm having a lower face lift next week with a reputable PS in Seattle and figured we could just add it to the procedure I was already scheduled for, so I asked him. Nope. He doesn't do it because the area is full of nerves and veins and it isn't his specialty. He gave me a list of 5 PS's in Seattle who he would recommend and none of those that I called said they do injections, fat transfers, or implants to the temples either. I'm 9 months post injection and my temples are still quite sunken, I'm pretty bummed that this might be as good as it gets.

An interesting thing I was told while discussing all this with Allergan is that Allergan is not required to list any side effect that they did not observe during their clinical trials. I said, well what about the medical studies that have been done where doctors have noted this side effect 100% of the time when the temple muscles have been injected? She said it doesn't matter if 1,000 doctors discover and write about a side effect that they found, and attribute it directly to Botox, Allergan would still be under no legal obligation to add that side effect to their patient literature.

However, the Allergan rep told me that if enough patients contact Allergan and report the side effect then they CAN add it as a potential side effect (note that she didn't say how many people are "enough"). I asked her how many people had reported this problem already? She said nobody, then she said she wasn't sure, then she said that there was no way to know how many because they could be calling it temple muscle atrophy, or temple wasting, or forehead dents, or whatever, so it would be impossible to add them up because there are too many ways to describe this problem.

So that, my friends, is why this KNOWN side effect is not in the patient literature, according to Allergan.

It was suggested today at the injecting doctor's office that I caused this temple deformity to happen to myself because I flew to Hawaii a month later and went scuba diving. Somehow when you get Botox I guess it makes your temple area so fragile that the increased pressure from scuba diving (or just from flying) can make your head squish. Or something. She was serious.