Question:

Just recently been treated for wet macular degeneration. I have prepaid for Botox for forehead between my eyes and crows feet. Is it safe to go ahead with it or should I try to get my money back? I don’t want to cause any more damage to my eyes. Thank you. 

Answer:

There should be no problem using Botox with your condition. It will not affect it in any adverse way. I wish you the best.

Question:

Dear Dr. Garcia,

I had Dysport injections in my forehead and sides of my nose over a month ago.  Within a week I started to get a large fluid filled bag under one eye and a chelazion which was treated by an opthalmologist.  It went away temporarily but then returned accompaied by itiching which I attributed to pollen allergy.  Again this dissipated but for the last three days I have had the swelling under both eyes without relief.  Can this be a side effect of the botox and is there anything I can do about it.  It is unsightly to say the least.  I have read that botox can cause the lymph system to not work properly and I wonder if this could be the cause.  I have never had pollen allergies before but I know that they can occur at any age.

Answer:

It is possible that the Botox injections to your nose moved toward the lower eyelid/ cheek region and weakened the muscles there to allow the fluid to accumulate. There is not much you can do except wait it out though. I do not think the chalazion, which commonly recurs due to inadequate removal, is related to the Botox though.

Question:

Forehead always raised without me even knowing I'm doing it.

Answer:

It is   a subconcious habit that is dificult to stop. Botox iis one answer. Cutting the muslces to weaken them, using surgery is another option.
 

Question:

Botox not lasting very long.

Answer:

What you describe depends on how many units were injected and where it was injected. For example, if the same amount is injected over a wider area compared to a small area, the effects will wear off sooner as there was not as much weakening of the receptors in the muscles. There is a small number of reported cases where people develop a tolerance, especially in people that have very strong muscle and animate a lot. I am assuming that the Botox was mixed properly, not over diluted and not used after four hours from mixing. 

Question:

Getting botox for eleven lines and a bit of a lift.

Answer:

The only thing I can think happened is that they injected the Botox above your eyebrows. To lift your eyebrows the Botox has to be injected into the muscles that pull the brow down. The muscles above your brow lift the brows and if you inject the Botox there, the brows will fall.

Question:

Botox not working

Answer:

your problem can be due to the fact that you need a larger dose, that they mixed the Botox too far in advance and it lost its potency, or it is fake Botox. Make sure you look at the box, make then open it in front of you, do not let them share the bottle with another patient,t and look for the hologram and then ask them how much they injected before and tell them it appears you need a larger dose

Question:

 

Hi Dr Garcia.

I had an Endoscopic brow lift nine years ago. i believe at that time a procedure was preformed to get rid of the frown lines between my eyes. The lines are pretty obvious now. Can I have Botox to correct or has something been done to those muscles that Botox can't fix?

I don't want to waste my money or have a bad result. 

Thank you for taking time to answer.

Answer:

I think it is fine to use Botox to soften the lines between your eyes after having a brow lift. There should be no negative effects and should give you a nice improvement.

Question:

I have been getting botox injections for many years for the eleven lines and forehead lines. When I first started getting them I never was told about much danger from botox. I now read about how dangerous it is and even death can occur. Do you think botox is safe or not?

Answer:

Botox, properly used and inejcted is very safe. There have been negative reports in the media, but it relates to certain types of animals that have had adverse effects.

Question:

I know that Botox bottles are single use only, and my physician does follow that. But I have a question. He opens a 100 unit vial for me and uses the whole thing (I have my forehead, glabella, periorbital and perioral areas as well as some of my platysmal bands treated): but when he mixes it with saline, he tells me that he gets 400 units out of that one bottle of 100 units. Am I getting 100 or 400 (!!) units of Botox when he treats me with one bottle? I don't understand. Thank you.

Answer:

That certainly is curious. The bottle only holds 100 units, so he might put in a larger amount of saline so he can disperse it over a larger area but it does not multiply it to 400 units. You are only getting 100 units

Question:

Botox injections

Answer:

The length of time the Botox will work depends on the amount injected and also the amount of muscle present. People with strong and larger muscle mass in the area of injection that are injected with just an average dose may not get as long as a result as people with smaller muscles and a larger dose. As to reducing the horizontal wrinkles of the forehead, Botox does have a potential to drop the eyebrows, again dependent on dose. It might require a small does of Botox at best, along with a filler for each individual wrinkle.

Question:
Answer:

Botox does well in reducing the bulk of the muscle. In some cases it is uneven from side to side though and there may be some slight weakness when biting and chewing

Question:

My derm used .4 ml of Botox on me this week. Was that 4 units or 40 units? Thank you.

Answer:

please see my previous response just a little before this one

Question:

I JUST ASKED THE QUESTIONS ABOUT BOTOX BUT FORGOT TO MENTION THAT I GOT IT FOR CROWS FEET & AS A RESULT, I HAVE WRINKLES UNDER MY EYES… HELP & THANK YOU!

Answer:

That is a pretty low dose for crows feet so I think the effect on your lower lid will wear off in a couple of weeks most likely.

Question:

I received botox (4 units per side) & now a week later, I have horizontal wrinkles under my eyes… above my cheeks. Is there anything I can do to fix this?

Answer:

I am afraid that all you can do is wait for it to wear off. In many cases after 3-4 weeks that problem gets better even though the entire dose has not worn off.

Question:

My PS wants to inject botox into my jawline. Wouldn't that relax the muscles there, causing my jawline to sag? Seems like a bad idea but he says he does this all the time. What is your opinion?

Answer:

It is not uncommon to inject the jawline further back near you ear if the muscles make your jaw in that area look too broad. Besides that, I am not sure what benefit, if any, it would give you further forward

Question:

I've been receiving Botox injections for the past 17 years. Always very happy with the results and with my excellent dermatologist. Unfortunately, last week, she inadvertently caused both a significant ectropion of one of my lower eyelids and--very oddly--a near total paralysis of the upper eyelid, just from her usual crow's feet injection. The upshot is that I cannot close that eye, which is an extremely painful and dangerous situation, and that I have a disturbing, creepy glassy-eyed stare. I saw my doctor yesterday, and we've decided that the only thing to do is to lubricate the eye every hour, keep the lid taped closed between lubricant dosing, and cover the eye with a patch while I wait for three months for the Botox to wear off. UGH! I believe she's right that this is the only available protocol to follow, but I found your website with my one good eye and thought I'd check. Any other suggestions? Need to hire a pirate in your practice for three months? This is hard to explain at my own job! Hey this is quite a service you provide! You're obviously a really good guy. Thanks!

Answer:

Protecting the cornea ss of paramount importance, yes. I will say that it likely will not take 3 months to resolve though. It would appear that she had some diffusion of the Botox into an undesired area and it is likely not  a large amount. In cases such as these I have seen issues like this resolve in a month or so. In the meantime I am afraid you will need to use the eye drops and keep the eye protected. I wish you the best and thank you for the kind words.

Question:
Answer:

An Happy New Year to you too! As to Neubelle, tha GFX technology has been around for a long time. It creates heat on the nerves that are working on the muscles that Botox is targeting. Does it work, yes. Is it permanent, no. Usually the muscle function returns in a year or so, maybe 18 months. I will say that I have heard from patients having RF therapy to ablate these nerves that it is uncomfortable to have it done. And of course it will be more expensive than a single sitting of Botox. Therefore you need to count how much Botox you will use in say 18 months and see price wise, which is better for you.

Question:
Answer:

Botox for that would be a bad idea as the muscle would be weakened and the lid might sag downward. It is either  alight laser peel or Retin-A, but the laser improvements will last about a year and the Retin-A is mild in degree of improvement. Surgery s done for skin quantity and it appears you have a skin quality issue, so surgery is not an option I am afraid.

Question:

Recently I was injected with Botox under the skin to soften the forehead instead of Botox being injected into the muscle. I was injecting Botox under the skin would soften the lines and not cause drooping eyelids. One week later my eyebrows have fallen slightly below the brow-bone and my eyelids droop.

Answer:

Botox diffuses and spreads into the muscles even if injected under the skin, so the effect of potential falling of the brows can happen, but it is dose related. The problem with a lower dose to avoid the fall of the brows is that you will not get the degree of animation wrinkle reduction that most patients want. Although it is frequently used for that, it is a well known side effect and one of the reasons that it is not FDA approved for such use.

Question:

I have never had Botox but my lids are droopy in the inner corners. I have discussed this with you before. I had a procedure done last March on the inner lids only, 2 sutures each eye. I didn't see any difference 4 months later and the doctor said it looked fine and how everyone would be happy to have eyes that looked like mine. I say 'Bull' and I still hate it. Would Botox help? How long would it last? Where would it be injected? Thank you Dr Garcia, you are the only person that makes me feel sane xoxo

Answer:

Botox is certainly worth a try. As to how long it might last, maybe 3-4 months. It would be injected into the muscles that depress the inner brow, so the corrugator and procerus muscles. Hope that helps.

Question:

Why did one eye get droopy after Botox injections? How long will that last and what should be done so that it doesn't happen again? p.s. that eye has always been a tad "squintier" than the other, but the Botox made a dramtaatic difference.

Answer:

it is because they injected over the eyebrow and the muscle the keeps the eyebrow up is now weak. It will usually get better before all of the Botox will go away but it can still take a few weeks to get better in most cases.There is nothing you can do to keep it from happening, it is all in the injector's hands and they should know that and warn you of that risk if you are having injections above your eyebrow.

Question:

The injector that I have seen for botox, has suggested that for slight marrionette lines she would inject slight amounts of botox on each side of my mouth. I'm terrified of the implications that something would actually paralyze the sides of my mouth. She explained it's more of a frowning motion than an actual crease. Should I refrain from this procedure? 

Answer:

if you injected it about halfway down from the oral commisure it can help to elevate the corner of the mouth. If it is a true marionette line, which is caused by the falling of lower cheek tissues over the ligament that spans the distance from the corner of the mouth to the jaw, then Botox will not fix it.

Question:
Answer:

We can do it but not all gummy smiles can be corrected with Botox and there can be side effects as with Botox in other areas of the face. In this case it will drop your upper lip, as that is desired, and that can make your speech a little different as the upper lip will not move as much as you are used to.