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Every year, more than 6 million doses of Botox, Dysport and Xeomin are administered to patients for cosmetic purposes. It is the most used cosmetic treatment regimen of all for good reason. It trumps the alternatives in many ways, it is not as invasive as cosmetic surgery for one, it is also less expensive and carries lower risks too. It’s effectiveness has never been in question since the FDA approved it for cosmetic use in 2002.

Botox extracts can also be used to treat other medical conditions like excessive sweating, migraines and the likes (in fact, it had been licensed by the FDA for such usage as early as the late 1980’s), but this article is focused on issues arising from its cosmetic use and the potential issues arising from poorly qualified injectors resulting in Botox gone wrong situations.



The working principle of Botox or Dysport is quite simple, it reduces wrinkles and fine lines by temporarily relaxing (paralyzing) the underlying muscles. The effect is temporary in the sense that after a few months, the relaxed muscles retain their tension and a new injection is required.


Just like any other medical or cosmetic treatment, Botox injections can go wrong.

When you see some Botox before and after pictures, it is even possible to assume that more damage has been done than good. There are many possible sources of errors when Botox is used. For example, the botulinum toxin in itself is extremely poisonous especially in concentrated states and can prove to be so if the proper concentration is not achieved before injecting into the body.

Apart from that, there are more instances of Botox gone wrong which include

1. Dilution, calculation and calibration errors.

2. Quantity error – too little or too much Botox.

3. Is the Botox in itself old, expired or flawed.

4. Problems arising from the patient’s anatomy.

5. Botox resistance.

6. Complications arising from use with fillers.

7. Injection errors – hitting a nerve or bad location of injection.

All of the errors listed above call into question one important factor – the surgeon’s credentials.

Ironically, the aim of using Botox, Dysport or Xeomin is to hide the evidences of aging, but when errors happen, this evidence is not only shown to the world, but it is shown in a worse way than bargained for. If you are dealing with an injector who is not highly qualified, the likelihood of botox gone wrong increases substanitally.

Every one of these situations can be avoided if he or she followed the right procedures, ascertained the right values, took the right precautions and so on. Many patients find themselves at the mercy of incompetent doctors because they are trying to cut costs. You do not want to put yourself in a position of botox gone wrong for the simple reason reason of trying to squeeze a few extra dollars out of a treatment.

The first precaution therefore is to avoid what seems too good to be true. Expectedly, Botox treatment is quite expensive, therefore having it offered for cheap can only mean that it is either not Botox or it is adulterated.

Some of these errors can also be life altering and life threatening, so prevention should be sought first. Do yourself a favor, realize the serous nature of botox treatments and the importance of dealing with a highly qualified botox specialist so that you can avoid the potential nightmare of botox gone wrong.


We’ve talked about bad Botox so far, but not everyone knows exactly what that looks like. Well, there are many different results – all them softly named to capture the gravity of the situation.

Some people have minor errors to sport, while others carry around scarring signs on their faces. Some of these Botox gone wrong results include:

1. The Narcissistic Brows

Personality aside, Botox gone wrong can give that Spock-like raised eyebrows that make it seem like people are carrying a constant sneer around with them. This usually happens when a forehead injection is off by a millimeter or so, meaning that those muscles drop too low and the eyebrow muscles stay up high.

To get the best picture of this, just imagine the picture of every sinister queen in any Disney movie.

Fortunately, it can be fixed quite easily. All the doctor needs to do is to strategically inject a few more doses of Botox to relax the muscles that won’t let the eyebrows relax and all should be fixed.

2. Quizzical Brows

When one eyebrow is arched differently from its twin – giving that constantly quizzical look.

This mild Botox situation occurs from either of two reasons, uneven Botox application or neglect of facial asymmetry in Botox calibration – most usually the latter.

This is one of the cases where your surgeon’s credentials is questioned again. A well designed Botox treatment regimen should take into cognizance factors like the symmetry if the patient’s face. Using generic values to make necessary calculations can cause a case of quizzical brows, hence Botox gone wrong.

3. Iron forehead

When the frontalis muscle is injected with too much quantity of Botox, it ends up causing this particular situation where the forehead looks immobile and ironed – too relaxed to look good. And since the said muscle connects to the movement of the eyebrows, they also get that over – relaxed attribute.

This occurs due to the doctors error in taking into account how much the patient uses this muscle.

It can make it hard for some patients to open their eyes properly – especially those who usually have to make more effort than usual to keep their eyes open because they have excess skin there.

Time is the only healing for this.

4. Eyelid droop

This is similar to the ironed, over – relaxed forehead, except that it is caused because the injection hit a nerve. It heals over time and the doctor can prescribe eye drops to remedy the situation while it corrects itself.

5. Deep freeze

This is when the face goes into an expressionless state. This is visible in celebs who end up looking like the only parts of their faces that move are their lips – everything else is deep frozen.

The cause if this is too much Botox injection especially in the forehead. While Botox can remove stress lines and give a perpetually calm face, too much of it results in a mechanical – looking frozen face, which is definitely a Botox gone wrong result you want to avoid.

6. Eyelid Ptosis

When facial no – fly zones like the eyelid muscles (levator palpebrae superiorus and levator aponeurosis)are fed some Botox, or when Botox creep into these zones form other areas, then we have ourselves a case of eyelid ptosis.

The eyelid muscled are relaxed and prevented from contracting, thereby “achieving” a constantly drooped look.

7. Droopy and lopsided features

Botox mistakes can ruin a number of facial features by making them droopy and lopsided, they include

Droopy smile

Happens when a Botox, Dysport or Xeomin injection makes one side of the lips droop lower than the other – altering it’s overall shape. This becomes visible clearly when the face is in motion, that is while smiling or frowning, giving a funny – looking frown and a lopsided smile. To avoid the Botox gone wrong situation, make sure to consult with only the most highly qualified Botox injectors.

Time is the only remedy here but doctors can prescribe palliatives while the situation corrects itself.

Facial Droop

When Botox from other regions migrate to the muscles that hold up the cheeks and relaxes them, making the face have a one – sided droop. The solution is time.

Lower eyelid droop.

Happens when the muscles around the eyes (orbicularis oculi) are overly relaxed, leading to an unwanted puffiness and creped look.

Generally, lopsided features can usually be fixed by injecting additional Botox into other strategic areas of the face to counter – balance the errors already made. But sometimes the error cannot be remedied and is left in the hands of father time to do his thing.


When the deed is done, what remains is to find the solution to it. While many Botox gone wrong situations can be fixed by additional Botox injections, others can be remedied while they are allowed to heal with time, the best solution possible is time.

Since Botox, Dysport and Xeomin wear off after 5-6 months, the issues usually go with it. The mistakes usually loosen its stranglehold gradually as the weeks progress, so some of it might actually be fixed before the Botox injection elapses.


We have mentioned that the only true solution to Botox gone wrong is prevention. It is best not to let it happen in the first place than to carry around such loud evidence of a botched process.

Preventive steps to be taken are very many, because Botox injection can be seen as a medical procedure – and should be handled as such – these precautions should never be skipped it substituted. In fact, when a doctor wants to skip them, these should be the first sign the he or she is not the real deal. These precautions include:


1. Only patronize approved and experienced professionals.

2. Don’t take any instructions by your doctor for granted.

3. Ensure that your doctor has all the information required like your skin type and every other possible complications that may arise.

4. Avoid using ibuprofen and any other drugs the doctor deems as non beneficial to you before your treatment.

5. Wherever you live, there is always a body responsible for certifying professionals like this – listen them. Before they are approved, these doctors have been properly tested to be sure that they know what needs to be known.

Patronizing unlicensed doctors may be cheaper, but they are accidents waiting to happen in more ways than one, and you are only putting your skin and life in a great deal of danger.

Experience cannot be dispensed with too, because you need someone who has seen things when errors occur to walk you through a solution.

Additionally, whom do you report to when things go wrong if you won’t listen to the licensing authorities? So look up and only patronize approved doctors for your Botox injections.



As stated above, if the price seems too good to be true, it probably is. Do not accept overly cheap Botox treatments unless you have unwavering faith in the doctor.

The average cost per unit is $10-$12 and you will usually need up to 15or 20 units per injection regimen. When you are offered extremely cheap Botox, remember they could be extremely dangerous too. Keep in mind the Botox cost depends on the number of syringes used per treatment area and the skill and the experience of the plastic surgeon injecting the Botox.

Sometimes cheap Botox is over – diluted and is incapable of effecting any treatment, resulting in what’s known as an under effect.


This is an off-shoot of overly diluted Botox mentioned above. Botox immunity happens when the Botox used for first – time treatment is diluted beyond necessary and therefore is lacking in its effect. The patients keep coming back for additional doses and when the weak Botox fails to work, the body can become immune to Botox.

Some shady operators are in the habit of shouting their Botox supplies, so this kind of case is on the rise.


If you are not sure about how to identify original Botox, then ask for help. This is your face we are talking about, you wouldn’t deliberately ruin it, would you?

Only buy from reputable sources – and referrals are very useful in this industry, so take them serious. Ask friends who have admirable success stories to show you the way.


Every injection is painful, even if minimal and the injections used for Botox treatments are very small so the pain itself is minimized as much as possible.


Botox treatments usually lasts up to 6 months before another round of treatment is required, but due to several factors, the time frame could be less. Factors like age, dermatological issues can shorten it lengthen the time.

Patients can also require touch – up injections, especially when the patient is a newbie.

Overall, the timeframe depends on the advice of the doctor.


Apart from errors, there are side effects that can arise from Botox usage. These side effects are numerous, but it is unusual for anyone to experience them all. They include inflammation, redness, pain at the injection sites, bruising, bleeding and so on.

Muscle spasms, numbness, dry mouth, headache, fatigue, droopy eyelids, fatigue issues are also possible side effects

Many of these side effects are also allergies playing out, asthma, wheezing, itching, rash, faintness, dizziness. If these allergic reactions begin, let your doctor know immediately, although your allergies should be taken into effect before a Botox treatment plan is designed for you.

A few of them can be avoided though, with experience and skill on the side of the injector to avoid problematic spots that might trigger allergies.

Other parts of the face can be affected by the Botox even though they are not directly the ones injected with the Botox. This happens because the Botox migrates around and can travel from the injection point in the forehead for example to other close sites like the eyebrows and eyelids.


Side effects are preventable if the right precautions are taken before hand. It is advisable to do the following to avoid the occurrence of one.

1. Inform your doctor of any allergies you may have and other conditions like asthma, breathing problems, bleeding problems, skin conditions and the likes.

2. A concentrated dosage is less likely to migrate to unwanted zones of the face than a highly diluted one.

3. Follow instructions about what kind of vitamins and medicines to avoid in the run up to your injection.

4. Do not use too much Botox because you want quicker results.

5. NEVER EVER self – apply Botox or use it in any setting other than when administered by a professional.


Grades of Botox have been designed to treat eye muscle problems, so if prescribed, it can be beneficial for the eyes.


1. Botox is not for you if you have undergone or plan to undergo facial surgery.

2. Pregnant women

3. People with certain ailments and skin conditions.

4. People with bleeding issues

5. People who take it who have recently taken certain medication

6. ALS sufferers it person with any other muscle limiting sickness.

7. Anyone who has ever had allergies to Botox or any of its derivatives.


The cost of Botox treatments vary depending on the quantity of the compound necessary to make the desired correction and whether you are using a combination of neuro and fillers.

Some outlets sell per quantity while some would have you pay per region on which it is applied, it goes for around $10-15 a bottle, but special offers can see that value reduce considerably. The Botox cost also depends on the number of syringes used, the number of treatment areas and on the highly skilled Botox injector you are using.

Financing is available in the office. Please inquire with the staff regarding your options.


In conclusion, just like everything else in life, there are risks associated with Botox usage, but these can all be navigated by doing the right things. It is also obvious that the advantages of Botox far outweigh all these easily navigable problems, the key is to do it right.

Finally, almost of these Botox gone wrong problems do not last very long, in a matter of weeks, they are corrected and worst still, in 5 or 6 month the effects wear off completely and you are ready for a new injection.

Father time to the rescue!

Learn more about how Botox is used in non-surgical procedures:

Non-Surgical Brow Lift

Liquid Facelift

Non-Surgical Blepharoplasty


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Interested in Botox, Dysport or Xeomin treatments? Look no further! If you need Botox, Dysport or Xeomin for crow’s feet, migraine, wrinkles, folds, shadows, sweating, and other common problems, get in touch with us today! Schedule a consultation and let us create a treatment plan designed for you. Call Dr. Sheffield today at our Santa Barbara location (805) 568-5988.

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