Can Botoxing some muscles create other lines?

I've been happy with Botox injections on the "11's" for several years. But recently I noticed that to the outside of one injected line, I get a raised puffy area when I smile. It creates a visible vertical line that to me looks much worse than the original wrinkle. I have an appointment with my doctor but while I am waiting for that am wondering if this is from another muscle compensating for the original and what might be done about it. The other side of the forehead is nice and flat but this raised area is very upsetting.

The muscles that causes the "11s" frown lines are the corrugator muscles – one on each side. Their anatomy actually varies more than you would think from person to person.  Some people have large, central muscles, others have muscles that are more vertical, some that are long, and flat along the brow line, etc. ….   Yours could be slightly longer along the brow line and the Botox injections are missing the lateral (toward the temple) fibers.  Those fibers can become more active and create that extra line or a "bunching" effect.  Please ask your dermatologist about this. 

It also could have something to do with the way your sleeping.  If the line is more obvious first thing in the morning and better as the day goes on – that ‘s a clue. Here is more on Botox Mistakes and How to Fix Them. Dr. I

Dr. Brandith Irwin, MD

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