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Dermal Fillers

When Botox Goes Wrong

Botulinum toxin reduces muscle movement activity by blocking signals released by nerves. It reduces skin folding and allows the skin to fill in wrinkles that have already developed. This article explains what happens when Botox goes wrong, among other aspects.

Continuous use prevents lines from becoming too visible. When Botox goes wrong, it could result from wrong pattern injection in the tissues or wrong amounts being administered, although it is rare. The results are dropped brows or eyelids on one side or both. Other patients can experience an overly frozen look or asymmetry. When this happens, one can seek re-injection or undoing of the treatment.

How Bad Botox Looks Like

When Botox goes wrong, here are examples of what an individual face looks like;

Frozen Face

When the forehead or smile is odd, expressionless and stiff, it could be a sign of excess Botox administration, which causes freezing. The face should move a bit after the treatment. It is fixed by strategically injecting on the brows to tone down the look or waiting for the treatment to wear off if over-injection is the issue.

Spock Eyebrow

King (2016)explained that when Botox is injected too low on the forehead, the muscle frontalis, which is responsible for raising the brows, will droop. It could be caused by the high dosage or improper diluting of the botulinum toxin. It is fixed by injecting small amounts of neurotoxin or dermal fillers to correct the asymmetry.

Eyelid Droop

Ruiz & Martin (2015)stated that this happens when botulinum toxin is injected in the wrong area, migrating to the eyelid and weakening the muscle that holds it up. Using a high dose on the forehead also over-paralyzes the muscles making the brow drop. It usually goes away without treatment within four to six weeks, and it is advisable not to rub the injected area the first hours after treatment to avoid drooping.

Facial Asymmetry

It happens when the treatment is distributed unevenly on the face. Administering too much on one side can cause the face to look uneven. It is fixed by adding more treatment to the areas with less.

No Difference

Botox should not cause a huge difference on the face, but the results should be noticeable. If the patient looks the same as before the treatment, the treatment did not work as intended, could be more diluted, or the amount administered was too little to make a difference. It is fixed by waiting at least 14 days, and the procedure is redone to satisfaction.

Factors Causing Botox To Go Wrong

Wrong injection technique

Not all aesthetic practitioners are qualified to perform botulinum injections. If one gets injected by an unskilled cosmetic doctor, they are likely to inject the wrong muscle, which could cause risks and complications.

Improper Placement

An experienced cosmetic doctor knows which area to inject and which area of the face should not be injected. If onevisits an unskilled cosmetic doctor, they could inject areas such as the nasal sidewalls, which should not be injected. Injecting deeply into the skin could also be of high risk.

Lack of Clear Communication

When the cosmetic doctor does not take the time to understand what the patient wants, the patient will be unsatisfied with the outcome of the injection. A patient needs to go for a consultation before the procedure so that they can discuss what their expectations are.

Botox Resistance

According to Proietti et al. (2021), this happens when there is a buildup of antibodies against botulinum toxin or the patient’s body metabolizes the treatment quicker.

Can Botox Be Reversed?

If the botulinum injection were wrongly injected, the medical expert would inject more Botox on the stronger side to loosen the muscle, which will help with an asymmetrical look and balance the face. If the problem is too much treatment and one has a frozen look, they will wait until the product wears off. It takes 3 to 4 months. Rouientann et al. (2019) explained that serious side effects or complications, such as dizziness and double vision, will need a cosmetic doctor immediately.

What to Look out for

Low prices

Botox is expensive. If a clinic offers cheap deals that are too good to be true, that could indicate an unskilled cosmetic doctor, or the products they are using could be expired. Research the most reputable clinics to ensure you get satisfying results.

The Cosmetic Doctor Does House Calls

Botox is done in a clinic. A qualified aesthetician should not be visiting the houses or offices of patients. It is advisable to visit the clinic to see the environment and cleanliness of the aesthetician and also to see previous patients they have injected.

The Aesthetician Specializes in Other Things

If the aesthetician does not specialize in cosmetic treatments, it could indicate they are not fully qualified. Not all cosmetic doctors should perform Botox; this could lead to serious complications.

Frequently Asked Questions about Botox

How Common Are Botox Complications?

Complications after Botox are rare because they are non-surgical and non-invasive; however, few cases of complication have been reported.

What Happens If Botox Is Injected Deeply into the Skin?

Injecting botulinum toxin too deep can cause side effects such as excessive swelling and bruising because the veins have been pushed too hard. The side effect is temporary, but bruising is visible.

Who Should Not Have Botox?

Botulinum injection should not be performed on pregnant and breastfeeding patients or people with skin infections. If one’s overall health is not okay, it is advisable to wait until one feels better.

Does Botox Increase Wrinkles?

Botulinum injection does not increase wrinkles after it wears off. The face usually returns to its original state.


Botox has a lot of benefits if one is thinking of having it. Book for consultation before the injection day to be aware of what it entails and what is expected of you. Have an idea of what you want so the aesthetician can know your treatment expectations. Visit a certified and trained cosmetic doctor for quality services. Botulinum toxin is quick and easy but can carry side effects if injected wrongly. After the injection, take precautions and instructions given by the cosmetic doctor to allow efficient healing.


King, M. (2016). Management of ptosis. The Clinical and aesthetic dermatology Journal, 9(12), E1.

Proietti, I., Skroza, N., Mambrin, A., Marraffa, F., Tolino, E., Bernardini, N., … & Potenza, C. (2021). Aesthetic Treatments in Cancer Patients. Clinical, Cosmetic and Investigational Dermatology, 14, 1831.

Rouientan, A., Otaghvar, H. A., Mahmoudvand, H., & Tizmaghz, A. (2019). A rare complication of botox injection: a case report. World journal of plastic surgery, 8(1), 116.

Ruiz-Rodriguez, R., & Martin-Gorgojo, A. (2015). Ten mistakes to avoid when injecting botulinum toxin. Actas Dermo-Sifiliográficas (English Edition), 106(6), 458-464.

Nataly Komova