Pros Explain How To Correct A Case Of Bad Botox - Byrdie

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Search Search Close search How to Correct a Bad Botox Injection—And Avoid Them in the Future By Kristin Howard

Kristin Howard Kristin Howard is a writer and content creator. She has contributed skincare and wellness articles for Reader's Digest, Hello Giggles, and The Pretty Pimple. Byrdie's Editorial Guidelines Updated on April 02, 2024 05:02PM Reviewed by Julia A. Siegel, MD

Reviewed by Julia A. Siegel, MD Julia A. Siegel, MD is a board-certified dermatologist based in Boston, Massachusetts. She is a member of the American Academy of Dermatology and has authored several peer-reviewed journal articles and book chapters. About Byrdie's Beauty & Wellness Board Board-Certified Dermatologist Fact checked by Anna Harris Fact checked by Anna Harris Anna Harris is an experienced fact-checker and researcher and a beauty writer and editor. LEARN ABOUT BYRDIE'S EDITORIAL GUIDELINES Close

A hand holding a vial and another hand holding a syringe — Stocksy

With the rise of any new beauty treatment comes the contrasting deluge of cautionary tales. In the era of injectibles, Botox has exploded in popularity and, naturally, so have cases of "bad" Botox. While its promises to halt the signs of aging usually hold true, sometimes too much of a good thing can produce not-so-stellar results. Some things that can happen? A poorly injected syringe could lead to eye droopiness (known as ptosis), visible bumps, lasting bruises, and less-than-desirable effects in other areas of the face. Fortunately, there are some steps to take to ensure the best possible outcome and even tips to ameliorate unsatisfactory results.

We spoke with Joshua Zeichner, MD, director of cosmetic and clinical research in Dermatology at Mount Sinai Hospital in New York City, and Annie Chiu, MD, board-certified dermatologist and founder of The Derm Institute, to find out exactly how to correct a “bad” Botox session and prevent it from happening again in the future.

Meet the Experts

Joshua Zeichner, MD, is a dermatologist, as well as the Director of Cosmetic and Clinical Research in Dermatology at the Mount Sinai Hospital in New York City.
Annie Chiu, MD, is a board-certified dermatologist and founder of The Derm Institute.

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Be Proactive by Understanding How Botox Works

Aside from conducting the necessary research before you proceed with Botox, the best way to get the results you want is to understand what Botox is, why it works, and how it’s used.

“Botulinum toxin works by blocking the signal released by your nerves which stimulates your muscles to constrict,” Dr. Zeichner says. “By relaxing specific muscles of facial expression, you can temporarily prevent the overlying skin from folding, which allows the skin to fill in wrinkles that have already developed. Continuous use can also prevent lines from becoming etched into the skin to begin with. These toxins are commonly used to treat the '11' wrinkles between the eyebrows, horizontal lines on the forehead, and crows feet wrinkles around the eyes.”

Dr. Zeichner says that your outcome depends on the pattern of injections in the face and how much of the toxin was administered. “The most concerning for patients is typically a dropped brow or eyelid, either on one side or both,” adds Dr. Chiu. “If Botox is placed too low or too much botox is used in the forehead, you can get flattened or heavy brow sensation.” Additionally, undesirable results from Botox may occur when muscles other than the intended target are relaxed.

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Find the Right Injector

This may be obvious to some, but when it comes to any beauty treatments, we prefer to err on the side of caution. Doing the research and investing in the right practitioner for the job is always the best, and safest, way to achieve your desired results. If you need to hear it from an expert, here it is:

“It is important to be treated by an experienced injector to minimize this risk," Dr. Zeichner says. "Getting bad Botox does not mean that Botox is bad. Your outcome depends on the skill and aesthetic of your injector. Just as you may not like a haircut at one salon, it doesn’t mean that you won’t be happy if you go to another one."

03 of 11

Communicate Clearly

Underwhelming results aren't always the cause of improper technique or lack of experience. Sometimes we're left unsatisfied with what would otherwise be considered an appropriate outcome because it doesn't fit the ideal we expected. The simplest way to ensure you walk away looking exactly as you envisioned is to clearly communicate, even over-communicate if necessary, what you're looking to achieve and what the best results look like for you. This process should be a co-creative one, with you as the chief visionary of your face. A skilled injector will be able to customize their technique to accomodate those needs, manage your expectations of what's possible, and even recommend alternative treatments that may better suit your vision.

04 of 11

Start Conservatively

A Botox experience can go awry if too much is administered, leading to an overly-frozen look—or if some of your muscles prove stronger than others, causing asymmetry. “I always tell patients it is best to start conservative, as everyone is a bit different in how much they react to Botox,” Dr. Chiu says. “It is easy to adjust by adding, but hard to take away if it looks unnatural or odd. Truly good Botox should be nearly undetectable, leaving you looking fresher and more rested, but not different in a noticeable way.” Whatever you opt to do with your Botox treatment, it’s best to start slow with a small dosage—aka "baby Botox"—and work your way up.

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Practice Patience

When it comes to Botox, there’s good news and bad news. The good news is that Botox is a procedure that produces temporary results, meaning even a “bad” case of Botox will eventually disappear over time. The bad news is that not much can be done to reverse the effects in the short-term. Being patient and allowing time to pass is your best bet at correcting the procedure. "Once you get the treatment, there is not much to do but wait for it to wear off, and results usually last between three and five months," says Dr. Zeichner.

If you think that your Botox appointment didn't give you the results you were after, your opinion might change in about a week or two. Dr. Chiu suggests waiting 10-14 days for the treatment to fully kick in. "Some of these issues are just a result of different muscles reacting to the product at different times," she explains.

06 of 11

Add More Botox if the Conditions Call for It

“If you have an issue that can be corrected by adding more Botox, then 'bad' Botox can be improved,” Dr. Zeichner says. This tactic won’t work for someone who has received too much Botox, which, again, often results in a “frozen” look, but it can help if the injections are asymmetrical, in which case, a bit more can be added to the other side of the face to even things out. For example: Because Botox temporarily weakens or paralyzes the muscle, if one side of the face is still able to move causing a "stronger" and more elevated look, then adding more Botox in that area will help to relax the muscle and even the plane.

Dr. Chiu concurs, saying you can see an injector to help correct the result, if the situation calls for it. "Injectors will know how best to correct but not 'overcorrect' your particular issue," she says.

07 of 11

Know When to Call It Quits

Sometimes, the best way to fix a problem is to take a hands-on approach, but this is definitely not always the case when it comes to cosmetic procedures, so always be sure to talk to your doctor before you automatically look to another session as the answer.

“More Botox is not necessarily better," warns Dr. Zeichner. "The goal of treatment is not to freeze the face completely, but rather to provide a natural appearance where the face can still move. Over-treating the forehead can result in the eyebrows becoming dropped or flat. Injecting only the middle of the forehead can cause a 'joker eyebrow,' where it looks over-arched. Over-treating the crows feet can actually interfere with your smile. Rarely treating the 11 lines can cause a droopy eyelid.”

08 of 11

Consider Copper

Because Botox paralyzes facial muscles by blocking the nerves, there isn’t much to be done to reverse the effect, although, according to a 2017 study, copper may inhibit the effects of the toxin. “Copper has been shown to help reverse the effects of Botox injections," offers Dr. Zeichner. "It is unclear, however, whether copper supplements or copper containing topicals may be effective in reversing the effects of Botox."

09 of 11

Stay Away From Zinc

While there is no magic ingredient that will immediately correct the effects of an undesired Botox job, some minerals may improve the effects of Botox. “Zinc may enhance the effect," says Dr. Zeichner, which in this case is the opposite of what you're looking to achieve. "Many doctors recommend their patients take zinc supplements when they get their treatment for a better outcome. Zinc is known for being effective in treating acne for its antioxidant properties, so be sure to check the ingredient labels for zinc on your skincare products."

Byrdie Tip

In terms of diet, zinc-rich foods include meat, eggs, whole grains, and legumes, but always make your overall health a priority before making changes.

10 of 11

Correct With Makeup

If you can’t reverse the effects of a cosmetic procedure, you can employ makeup tricks to disguise unwanted effects (or enhance others). “You may be able to apply your makeup in a different way to compensate for the changes associated with bad Botox,” Dr. Zeichner says. Drooping eyes can be made to appear lifted by focusing on the lashes, or adding concealer, highlighter, or winged eyeliner, in some cases. Brows can be evened out with brow pencil, powder, or gel, and styling your hair to complement your facial structure can be a quick, temporary fix while you wait for the effects of Botox to wear off.

11 of 11

Familiarize Yourself With Alternative Botulinum Toxin Brands

The term “Botox” has become synonymous with botulinum toxin, but there are actually several brands of the ingredients available, some of which may yield different results depending on the person.

“Botox is one brand of botulinum toxin used cosmetically to improve the appearance of wrinkles caused by facial expressions," explains Dr. Zeichner. "Other brands of botulinum currently available include Dysport, Xeomin, and Jeuveau." Along with these, Dr. Zeichner says there are two toxins being developed that should come to the market. "The first is called Bonti from Allergan, The makers of Botox," he says. "This toxin has a quick onset of action, and its effects are short-lived. It will be a good option for first-timers or for people who need to get a last-minute treatment. Daxxify is a longer lasting toxin from Revance Therapeutics [and] should give improvement for at least six months.”

The Takeaway

If your Botox appointment didn't give you the results you were after, make sure to, first, wait 10-14 days for the treatment to fully kick in. If you're still not satisfied, there may not be much that can truly reverse the results other than it wearing away on its own. If you're determined, speak with a professional. They will be able to assess your concerns and provide options to potentially alleviate the effects using additional Botox, treatments with copper, and more.

Article Sources Byrdie takes every opportunity to use high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial guidelines to learn more about how we keep our content accurate, reliable and trustworthy.

Bremer PT, Pellett S, Carolan JP, et al. Metal ions effectively ablate the action of botulinum neurotoxin A. J Am Chem Soc. 2017;139(21):7264-7272. doi:10.1021/jacs.7b01084