Are There Zones Where Botox Should Not Be Injected?

If the face looking back at you in the mirror looks perpetually tired or if fine lines and wrinkles are forming and threatening to give away your age, you may wish to consider Botox injections.

If you have done any internet research at all about Botox, there is a good chance you have read horror stories of Botox injections gone wrong. You might imagine horribly frozen faces, puffiness, droopy eyes, and sideways smiles that make you hesitant to even try Botox.

The majority of these stories are true, and they all have one common denominator: the Botox injections were administered in the wrong place or were done incorrectly. Botox injections can provide natural, subtle results that refresh your face and make you look more rested and even younger, but they need to be done properly.

Today we are going to discuss Botox danger zones, the mistakes that can be made with these injections, and how to ensure they don’t happen to you.

It Is Important To Carefully Select Your Botox Injector

This may be hard to believe, but it is important for you to know that not all clinical injectors possess extensive proficiency in injectables. Also, depending on the legislation in their state, some practitioners have little to no formal training, experience, or expertise in the administration of Botox injections.

In contrast, board-certified cosmetic surgeons and dermatologists must have years of comprehensive medical training, and they also must have a molecular-level grasp of how the very complex facial muscles, tissues, and nerves interact. A board-certified cosmetic surgeon or dermatologist should be the only “professional” you trust with your Botox injections to guarantee safe results and ensure that the danger zones for Botox on the face are avoided.

An inexperienced injector may not be trained to know that the area that needs correction is not always where the injection is placed to make that correction. Almost every adverse Botox event is caused by improper placement of the injection.

The Approved Areas For Botox Treatments

Botox can work anywhere on the face where there are muscles. Botox’s ability to relax or temporarily paralyze a muscle has many beneficial applications, but it can also create undesirable side effects.

Botox is most effective when administered to the upper portion of the face. For instance, in the area between the eyes and brows known as the glabella or forehead muscles and crow’s feet, which form on the outsides of the eyes when you squint or smile.

Botox has been approved by the FDA for adult use in treating moderate-to-severe forehead lines, frown lines between the eyebrows, and fine lines called crow’s feet. Botox injections used to treat any other portion of the face are considered “off-label”.

Certain areas on the face carry a higher risk factor for unwanted results due to their underlying structures. The lower portion of the face has more sensitive areas, and the mouth area requires particular expertise to avoid unwanted complications. (asymmetrical smile, difficulty speaking, etc.)

Botox Danger Zones On The Face

Illustration: Botox areas to avoid

1. The Frontalis Muscles
The Frontalis muscles are a group of muscles located at the front of the skull, just above the brows. These muscles raise the eyebrows and can cause wrinkles to form on the forehead. These are danger zones and should be avoided. If these are injected with Botox, you can end up with unnaturally arched eyebrows, which have been comically named “Spock Brows” (the Mephisto Effect).

Botox should be injected into the smaller muscles around the eyebrows that are responsible for moving your eyebrows inward. (the corrugator supercilii muscles)

2. In The Wrong Location Of The Orbicularis Muscle
These muscles help open and close your eyes and also help tears drain properly from your eyes. They are located in both the upper and lower eyelids. It is critical that Botox is not injected into the wrong area of these muscles when correcting crow’s feet, or it may weaken the muscle and cause the eyelid to droop (ptosis). Although uncommon, ptosis can impair vision.

Likewise, if Botox injections are administered in the wrong place in the lower eyelid, it can cause exaggerated undereye bags. If you already have under-eye issues, misplaced Botox can exacerbate them.

3. The Muscles In The Chin
Some patients might request Botox in their chin to smooth out some wrinkling or dimpling, but the chin is a danger zone for Botox injections and can give you a distorted smile or cause a lisp when you speak (It may appear as if you had a stroke).

Using Botox in the lower part of the face is considered “off-label use,” which is a fancy way of saying that the FDA has not granted approval for the use of Botox in that area. Although still off-label, Botox can be used on enlarged masseter muscles (which connect the cheekbone with the lower jawbone) to create a more slimming look to the jawline and alleviate jaw clenching and teeth grinding.

4. The Mouth And Lip Area
Botox injections around the lips require expert handling so the arteries that carry the lips’ blood supply are not damaged. Botox can also relax mouth muscles to the degree that it affects the patient’s ability to pucker, whistle, drink with a straw, kiss, or enunciate when they speak.
5. Just Under The Skin
Botox is only effective if it is injected into the muscle, so it is essential that the individual administering Botox knows what they are doing. If they only inject it under the skin, it will not have the desired effect.

Botox and dermal fillers can safely and effectively correct cosmetic imperfections and give you an overall refreshed, rested, and more youthful appearance. The key to having the best experience with anti-aging treatments is the experience and expertise of an injector who also knows the danger zones for Botox and fillers.

If you are interested in learning more about Botox or other cosmetic injectables, contact Surgicare Arts & Aesthetics to set up your consultation today. Our team of professionals can answer your questions and provide you with any information you need to determine how to best address your concerns.

Dr. Angelina Postoev of Surgicare Arts & Aesthetics, a triple board-certified cosmetic surgeon, has extensive knowledge and training in Botox and dermal fillers. She and her expertly qualified team are ready to help you look and feel your best! Contact us today for your appointment.

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