Blog with Dr. Irwin

Botox Mistakes

Is this a Botox mistake?

Posted in Botox Mistakes, Botox, 2012 on Jan 08, 2012 | Permalink

Hello Dr Irwin, I could really do with your advice. I have recently had botox for the second time. Both times my eyebrows have dropped! Help! I'm 34 years old and just had botox between my brows and above them, but not up into my forehead. Above my eyebrows is now smooth, but the brows have dropped and are 'crowding' my eyes. Both my eyes are very hooded making me look tired and angry! I went to a good doctor and the second time he did two less injections than the first to avoid this. Why has this happened, and am I just a poor candidate for botox? Thankyou Claire.x

Usually with Botox, it's a placement and/or dose problem. What's tricky about Botox is that we are all individuals and our facial muscle activity is not always the same. That's why it... more

Is this a problem with Botox dosing?

Posted in Botox Mistakes, Botox, 2012 on Jan 08, 2012 | Permalink

Dr. Irwin, I received my first Botox injection about 4 weeks ago. My first injection was about 25 units spread over my forehead and 11 lines and 3 on each of my crows feet. I returned because My 11 lines were still very prominent as were some other wrinkles in my forehead. This time I received another 30 units. After two weeks I couldn't tell a difference and returned today where she says she injected another 30 units into my forehead, but said she couldn't do anything about my 11 lines. 90 units of Botox seems excessive to me as I am only 35 years old. Do you think she is diluting the Botox or is this normal to take this many unit to correct my lines?

Generally, and I'm sure other Dermatologists would say this also, the first dose of approximately 25 units is quite reasonable and will be in the ballpark for many younger women for the... more

Is it possible to relax forehead lines AND lift the brow with Botox?

Posted in Botox Mistakes, Botox, 2011 on Dec 31, 2011 | Permalink

Hello Dr. Irwin love the site :) Botox question here. Is it possible to relax the forehead lines AND create a brow lift at the same time? If so....how does this work? Thank you in advance for your answer and this great site, you are appreciated!

Yes ...... but only to a certain point. Many people who have 'hooding' (that excess skin) of the upper eyelid, use the forehead muscle (the frontalis) to pull up the eyebrows. By... more

A doctor asks a question about Botox.

Posted in Botox Mistakes, Botox, 2011 on Nov 13, 2011 | Permalink

I've been injecting Botox for patients for a few years with very good results. Recently a petient returned after her treatment with a horizontal line above the bridge of her nose which was more prominent after the Botox treatment.The forehead and 11 lines of the glabella are fine. What would you suggest. Thanks, Dr Steve W

Dr. Steve - As a doctor you are always welcome to call my office number and ask my staff to take a message. I'm happy to call you to discuss also. In general, if that horizontal... more

A doctor asks a question about Botox.

Posted in Botox Mistakes, Botox, 2011 on Nov 13, 2011 | Permalink

I've been injecting botox for patients for a few years with very good results. Recently a petient returned after her treatment with a horizontal line above the bridge of her nose which was more prominent after the botox treatment.The forehead and 11's lines of the glabella are fine.What would you suggest .Thanks, Dr Steve W

Dr. Steve - As a doctor you are always welcome to call my office number and ask my staff to take a message. I'm happy to call you to discuss also. In general, if that horizontal line at... more

Is this Botox info true?

Posted in Botox Mistakes, Botox, 2011 on Sep 14, 2011 | Permalink

Hello Dr Irwin, I have booked an appointment to have Botox injected into my forehead for the first time. When I spoke to the Doctor she said that there was a 20% chance of drooping of my eyes if I didn't get another injection between my eyes also. Is this true? Andrea

Wow - maybe this was a misunderstanding? ? It's hard to know if that' s what she really meant. A Botox injection between your eyes won't droop your eyelids. And as for droopy eyelids,... more

Are Botox and Thermage compatible?

Posted in Thermage and Radiofrequency Devices, Thermage, Radiofrequency systems, Botox Mistakes, Botox, 2011 on Sep 11, 2011 | Permalink

Hi Dr Irwin, Can you please tell me if Thermage or radio frequency treatment can be performed if you have had had Botox within a month? I was about to have a radio frequency treatment and when my therapist realized I had recently had Botox, she said I have to wait 4 months to have the treatment as the paralyzed muscle would become irritated from the increased collagen... Is this correct? I have read your article about Thermage and you only mention to avoid dermal fillers and Sculptura... Regards Sharon, Perth Western Australia

She's not correct on this one. Botox is injected into muscles and binds there within about 6 hours. Most doctors tell their patients to be moderately careful for 24 hours or so - ie don't... more

Can Botoxing some muscles create other lines?

Posted in Wrinkles, Botox Mistakes, Botox, 2011 on Sep 11, 2011 | Permalink

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... more

What do I do about a Dysport mistake?

Posted in Dysport, Botox Mistakes, Botox, 2011 on Sep 07, 2011 | Permalink

I just had Dysport injections a few days ago. Both of my brows are considerably lower, and both eyelids are droopy as well. Although that is a problem in itself, the more important situation, is my right eyelid is drooping so much that it is covering my eye! My neighbor said it looks like I've had a stroke! Is there anything at all that I can do to reverse this and if not, how long will I have to suffer with it?

Okay - I don't want to sound like a nag but........ have you called your doctor??? He/she is the person who needs to hear about this! And, yes there are things to help you with this... more

The dreaded over Botoxed problem!

Posted in Botox Mistakes, Botox, 2011 on Sep 03, 2011 | Permalink

I had a Botox treatment a week ago and I really don''t like it... Is there a way to make it go away faster and how long is it going to take to wear off?

One of my pet peeves is over Botoxing. It seems to me that many injectors really have a heavy hand and often less is better! Sometimes much less!

In your situation, you just have let... more

Can this Botox mistake be fixed?

Posted in Botox Mistakes, Botox, 2011 on May 25, 2011 | Permalink

I had botox on my forehead and the results were fantastic however, the np talked me into it for my marionette lines instead of restylin becaue they are tiny. One week later and one side of my lower lip is a bit paraylized and achy. Is there anything you know of to decrease this besides exercising the muscle?

No, unfortunately, you are stuck with this one until it wears off. Trying to activate the muscles involved frequently may help a little. Please see my article on Botox Mistakes and How... more

Dysport/Botox mistakes!

Posted in Dysport, Botox Mistakes, Botox, 2011 on Apr 16, 2011 | Permalink

I had 60 units of dysport injected a week ago in my forehead/between my brows for the first time. I am very unhappy with what seems like the bridge of nose being widened making my eyes seem wideset and the lids are heavy. My forehead feels like cement and my eyes kind of ache. Do you think the distorted look of my eyes and nose will resolve?

To reassure you, the effects of Dysport/Botox are temporary and will resolve. It's difficult to predict the time frame but in general it takes 3-6 months to wear off completely. You may... more

When is it okay to do Thermage after Botox?

Posted in Thermage and Radiofrequency Devices, Thermage, Dysport, Botox Mistakes, Botox, 2011 on Mar 27, 2011 | Permalink

Is it safe to have thermage done around 2 days after botox for crow's fleet and forehead lines? Will it cause the migration of botox to other regions and thus causing complication or ineffectiveness?

It's fine to do the Thermage the next day even after Botox. It doesn't take the Botox long to bind to the proper receptors at the junction between the nerve fiber and the muscle. And,... more

Why would Botox wear off quickly suddenly?

Posted in Botox Mistakes, Botox, 2010 on Oct 21, 2010 | Permalink

Dear Dr.I, Why would botox wear off in a month? I have done botox on my forehead and crows feet in the past and it lasts 3-5 months. I just had the squint lines (between the eyebrows and I realize my lines are back???? Why would it last such little time? Thank you

I'm glad you asked this because there are several different reasons. I'm assuming you went to your usual doctor and that they are mixing the Botox the same way each time. If the... more

Pregnancy and cosmetic procedures - what is advised!

Posted in Pregnancy, Botox Mistakes, Botox, 2010 on Oct 21, 2010 | Permalink

Hi Dr.I- I have sun spots that I manage with IPL treatments and the hydroquinone 4% and I love Botox for my crows feet. I just found out I am pregnant-8 weeks (completely unexpected) and I just had an IPL and botox prior to finding out. How damaging can that be? I love your site and appreciate your time. Thank you.

Okay ......... let's take these one by one. The IPL is just light on the surface of the skin. and I have never any reports of pregnancy related problems. We do not treat pregnant... more

Can this Botox mistake be corrected?

Posted in Botox Mistakes, Botox, 2010 on Sep 26, 2010 | Permalink

I found your site searching for solutions to Botox mistakes, I had injections in the chin area which gave me a lopsided smile. It is not apparent if not smiling but has caused me not to smile anymore. When should this effect wear off and is there anything that can be done to fix this? I went to a plastic surgeon and trusted he knew how to do this, I initially went for the forehead area but he talked me into the chin to help raise the corners of the mouth and fix a dimpled chin. I'm worried thinking this is permanent, it has been 10 days since the injections. Please let me know if there is help, i would fly to your office if you can correct this. Thank you!

I wish I had a magic wand for you, could just wave it and this would go away fast. But first let me reassure you. This is NOT permanent! It will go away but it could take anywhere... more

I've had 4 Botox appointments with the same doctor and the problem still isn't solved?

Posted in Finding a Good Doctor, Botox Mistakes, Botox, 2010 on Aug 17, 2010 | Permalink

Hi Dr. I- I had Botox on the bunny lines and under the eyes. I have been back four times for the follow up because my left side hasn't really changed at all. One side/right side is great-smooth and wrinkel free after the 2nd treatment. The doctor said I had strong muscles on the left side and thought #4 would do the trick. It's been 7 days since that treatment and it looks the same. Is that normal? I plan to make another appointment but why would one side require so much more than the other side????

Since I don't know what you looked like before and I don't know exactly what was done, I can't really comment. But as a general rule, it doesn't make sense to me that one side is... more

How can my friends and I figure out unit pricing for Botox?

Posted in Botox Mistakes, Botox, 2010 on Jul 08, 2010 | Permalink | View Comments (1)

Botox pricing: Having a discussion with friends on the cost of botox. My MD charges by the area. On the realself.com, many derms, plastic surgeons comment. Some say they charge by area, some or most by unit. What do you think? Is unit pricing more transparent and accurate or by area? Thank you.

Okay - so this is where I really disagree with the vast majority of doctors who inject Botox, many of whom do an excellent job. I don't do either - at my office we charge by volume... more

I think I still have marks from Botox six weeks ago, what should I do?

Posted in Botox Mistakes, Botox, 2010 on Jun 29, 2010 | Permalink

I had botox approx six weeks ago, I had an injection between the eye area and still see the prick from the needle, there is also one side of my face at the corner of my left eye toward the ridge of my nose that has a bump that almost feels like cartilidge, could that happen as a result of botox and if so what do I do? I really need help and would appreciate your response.

Please, please, please call your doctor who did the Botox injections!! I can't emphasize enough the importance of following up with him/her. The doctor who did the procedure is the... more

Botox problem??

Posted in Botox Mistakes, Botox on Jul 28, 2009 | Permalink

Hi Dr.; i had botox injected june 11th. the dr. has an office, but he injects botox @ my beauty salon. the following day my eyes were sagging, then the left side of my face started drooping; my speech is greatly impaired and i have not sense of taste. the botox dr. made me wait for about a week before he would see me. when i went to the appt., his assistant told me that i had an abcess in my tooth. eventually my primary dr's pretty much agree with me that the botox created this problem; however during the 3-4 months until all botox is out of my system, they are medicating me with myasthenia gravis to see if my speech could be helped. can too much botox give you myasthenia gravis? thanks.

These are good questions and my heart goes out to you since I'm sure this has been difficult for you.

I am speaking generally here because I can't see you and these are general... more

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