Botulinum toxin is one of the most widely used methods for rejuvenation, and because it has been tested on millions of patients, it is one of the safest and most popular methods. Unfortunately, today, it is being administered in what we call “back-alley” conditions by people who do not know anatomy and do not know the difference between subcutaneous injection, intramuscular injection, or the difference between the two.
Botox is a short-term procedure that can be considered straightforward for a doctor. There are approximately 40 facial muscles, each with a distinct function. Without anatomical knowledge, it is impossible to predict the response when blocking a specific muscle. Some muscles are blocked using intramuscular injections, while others are blocked by taking advantage of subcutaneous diffusion. If the difference between the two is not understood, and an intramuscular injection is administered where a subcutaneous injection should be given, complications such as drooping eyelids may occur. Since muscle strength and facial shape vary from person to person, the doses administered at each point also vary.
There are areas where Botox should never be applied, as drooping eyelids could be the most innocent complication you might experience. Incorrect application can result in paralysis, blindness, double vision, and regional numbness. There are also areas where Botox application is risky and must be performed with extreme caution. For example, if masseter Botox (teeth grinding Botox) is administered where the smile nerve passes, it can cause smile asymmetry. Similarly, Botox administered for upper lip lines can cause lip asymmetry.
Another problem with basement Botox is the toxin they use. We doctors obtain Botox from pharmaceutical companies and prove that we are professionals in this field by providing evidence ranging from our diploma numbers to our tax certificates. It is impossible for basement Botox to be the original drug. If you factor in commercial concerns, the fee you pay is likely for counterfeit Botox administered at half the price, and you should be prepared for surprises. Unfortunately, once your eyelid droops, we cannot correct it because it is an irreversible complication, and we must wait for the Botox effect to wear off.
Another issue is complication management. No one who does not know how to treat allergies should pick up a syringe and inject anything, and Botox is no exception. Especially since the content of counterfeit Botox is unknown, the risk of developing an allergy is higher.
Even a slight miscalculation in the placement of Botox or a tiny overdose can make you very unhappy when you are trying to improve your appearance. When it comes to Botox, there is a fine line between great results and terrible results. To me, successful Botox means achieving a fresh and youthful appearance while maintaining our natural look. If your face looks younger but no one can tell you’ve had Botox, that’s success. A forehead that looks ironed out but with low eyebrows, or eyebrows that are overly arched and lifted like Mr. Spock from Star Trek, can result from even the smallest dosage errors. If you don’t want to leave this to chance and want to have someone accountable for the procedure afterward, I strongly recommend having your Botox done by a doctor.