Dr. Sam Lam Plastic Surgery Forum

answering that question requires my seeing the individual. however, just in general, here are things that could be happening:
1. the botox was placed to "chase" a wrinkle that extended down the face. when the botox is administered too low, i.e., away from immediately near the eye, the injector can paralyze the zygomaticus muscle which can affect the smile. the goal is to start botox before lines go halfway down the face. if they have already have that, do not chase those wrinkles but just be more religious in botox administration to have the lines slowly draw back inward and gradually disappear if you are not too far gone. start botox early!
2. the person needs a lower dose in that if the orbicularis muscle around the eyes is totally frozen and the cheek is not, then there can be too much differential movement of one area abutting the other area. another technique is to place the botox at what i call a torquing point which is where the cheek draws up into the lower eyelid. i botox that little lower corner underneath the eye to relax the orbicularis so that the cheek does not overly draw into the eye. this is almost impossible to explain in a forum setting. i also modulate the injection under the eye to improve that situation.
those are just two thoughts. obviously anything could have happened. don't let one bad botox experience jade you from doing it. go to an experienced injector. i tend to inject 8 to 10 injections around each eye to make my results smoother. most people wind up doing only 2 to 3 because they bruise and hurt patients whereas my finger technique you should not feel even a single needle entry.
best,
sml