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  • It is currently Wed Jun 19, 2013 9:12 pm

botox and smiling

This section of the forum is dedicated to discussions on the use of Botox for facial rejuvenation, wrinkle reduction, jaw reduction, and excessive sweating.
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botox and smiling

Postby proxy » Fri Nov 13, 2009 2:43 pm

Hello,
I have a question regarding smiling after injecting botox around the eyes. I am thinking about getting botox around the crows feet area but after I saw my friend who got botox around the eye area I am wondering: is it normal that her smile was really strange (very restrained and her cheeks seemed a lot fuller but not in a good way). Could it be poor administration of botox or overdoing it? Or is the "cheeky" smile often the consequence of botox around the eye area? I must say I haven't noticed the weird smiling with other people who get botox regularly.

Thank you so much for your answers on this forum, it's very helpful!
proxy
 
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Re: botox and smiling

Postby dr. lam » Sat Nov 14, 2009 12:53 pm

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
Samuel M. Lam, M.D., F.A.C.S.
Diplomate, American Board of Facial Plastic & Reconstructive Surgery
Diplomate, American Board of Otolaryngology Head & Neck Surgery
Diplomate, American Board of Hair Restoration Surgery
dr. lam
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