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Will cheek drop and jowling from Botox resolve over time if Botox was used excessively?

Dr. Dean Kane Botox Q & A shutterstock_38139943

Q. I first had a Botox injection in September 2014 at a Medspa. The doctor suggested I come back in 5-7 days. He did more. Then he said I should come in every 6 weeks. It looked good at first and in December I noticed my cheeks looked big. But I kept going getting anywhere from 10-20 units injected every 6 weeks in the crows feet. Now, I’ve not been in 3 months because my cheeks dropped, I have jowls and a double chin. All my fat has dropped to my lower face. Will this resolve in time? My cheeks are flat. I look awful.

A. ​The use of Botox like any medical procedure is art and science. Botox works by relaxing muscles. The muscles of the face are functional and expressive.

​If a muscle that provides both lift of the cheeks and jowls and creates expression around the eyes are relaxed, you will obtain both actions; a reduction in lines of the lower eyelids and crows feet but also,  the inability to lift the soft tissues (skin, fat, muscle) which that muscle normally lifts.

​The circular muscle around the eye performs the above (and so much more) that if relaxed, will eventually allow the cheek and jowl to descend. It may also relax that portion of the muscle which pushes the under eyelid fat bags inside, closes the eye for protection and pumps tears down a internal drain.

​Botox wears off in a average time of 3 to 4 months. With re-injection, the muscles tend to atrophy and may need stimulation to start back up again to perform their original function. If this does not happen for you, seek consultation from a rehabilitation specialist.

​You can appreciate then the trade-offs of proper Botox injection and the experience, skill, talent and understanding of the anatomy and consequences of even a publicly considered “simple” procedure. It is best to consult with a Board Certified and talented Plastic Surgeon, ENT Facial Surgeon and / or Dermatologist for your best results.

​I hope this has been helpful! All the best!

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