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On 05

Feb

2025

| By

By Ross A. Clevens, MD, FAC and Jurry Om, FNP-C

Botox is one of the most trusted and effective ways to smooth fine lines and wrinkles, helping you look refreshed and youthful. But achieving beautiful, natural-looking results depends entirely on who is performing your treatment.

When Botox is in the hands of a highly trained, experienced injector, you can expect stunning, subtle results. However, when administered improperly, unwanted side effects can occur. Your master injector will also help you choose which ‘Tox,’ is best for you among the nearly identical products: Botox, Xeomin, Dysport, Jeuveau and Daxxify.

Here are five things that should never happen when you get Botox—and how to make sure you’re in the right hands.

1. Droopy Eyelids (Ptosis)

One of the biggest concerns patients have about Botox is the risk of droopy eyelids. This happens when Botox spreads to unintended muscles, weakening them and creating a heavy, tired appearance.

Why it happens:

  • Incorrect placement of Botox, especially near the eyebrow.
  • Lack of precision, leading to Botox migrating to surrounding muscles.
  • Improper mixing of Botox.

How to avoid it:
A master injector understands exactly where and how much Botox to administer to achieve a natural, lifted result. They also provide detailed aftercare instructions, like avoiding lying down or rubbing the area immediately after treatment, to prevent unwanted migration.

2. Asymmetrical Results

Your face is naturally unique, and Botox should enhance that—not create unevenness. If one eyebrow sits noticeably higher than the other or your smile appears lopsided, it means the Botox was not injected with proper balance.

Why it happens:

  • Injecting uneven amounts of Botox on either side of the face.
  • Failing to account for natural differences in muscle strength.

How to avoid it:
An expert injector takes time to carefully assess your facial structure, expression and muscle activity before treatment. They will also schedule a follow-up visit to ensure your results are symmetrical and make any necessary adjustments to fine tune the ideal result for you.

3. Frozen or Overdone Look

A well-done Botox treatment should leave you looking like the best version of yourself—not stiff, expressionless, or overdone.

Why it happens:

  • Using too much Botox in one area.
  • Ignoring your natural expressions and aesthetic goals.

How to avoid it:
A skilled injector tailors Botox to you, preserving natural movement while softening lines. The goal is never to freeze your face but to create a refreshed, youthful appearance. Make sure your provider listens to your concerns and customizes your treatment plan accordingly.

4. Excessive Bruising or Swelling

Some minor swelling or bruising is normal, but if it’s severe or lasts longer than expected, it could be a sign of poor technique.

Why it happens:

  • Hitting a blood vessel during injection.
  • Using needles that are not extra fine or are dull.
  • Not following pre-treatment recommendations, such as avoiding blood-thinning medications.

How to avoid it:
A well-trained injector knows how to minimize trauma to your skin and underlying tissues. They will also provide clear pre- and post-treatment instructions to help you heal quickly and comfortably.

5. Infection

Botox is a minimally invasive treatment, but cleanliness and proper technique are still essential to avoid complications like infection.

Why it happens:

  • Poor hygiene or non-sterile equipment.
  • Non-sterile mixing of Botox.
  • Touching the injection site with unclean hands after treatment.

How to avoid it:
Always choose a licensed professional with a spotless reputation for safety. During your appointment, ensure they use sterile techniques, and follow their aftercare instructions carefully.

The Bottom Line: Your Injector Makes ALL the Difference

Almost all unwanted Botox side effects come down to one thing: the skill and experience of your injector. When choosing a provider, look for:

Extensive Training – Ensure they have specialized expertise in Botox and a deep understanding of facial anatomy.
Proven Reputation – Read reviews, ask for recommendations, and check before-and-after photos.
Personalized Approach – A great injector listens, customizes your treatment, and ensures natural, balanced results.

Invest in Expertise—Because Your Face Deserves the Best

Botox should enhance your natural beauty, not lead to complications that could have been avoided. Choosing a highly trained, experienced injector means you’ll walk away looking refreshed, confident, and never overdone.

When it comes to your face, expertise isn’t just important—it’s everything.


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