When Botox and Restylane Goes Wrong…

Botox: Yep, she’s done more than just “try” Botox. She’s a regular. How do we know? Because she’s developed a tell-tale sign of long-term...

We all know and love the famous actress pictured below. Although many stars deny using any type of cosmetic injection treatments to keep them looking young and beautiful, at the end of the day, it is their job to look good. It’s a good bet that almost all of them do! So, back to our friend below. Yes, she is beautiful, but when you look at this picture, you probably think something is a bit off…and you’re right! Let us tell you more about what’s gone wrong with this actress’s look.

Botox: Yep, she’s done more than just “try” Botox. She’s a regular. How do we know? Because she’s developed a tell-tale sign of long-term Botox use known as “bunny lines”. Do you see those little lines on the side of her nose? Notice that the rest of her forehead, between her eyes and even her crow’s feet area looks almost perfectly smooth when she smiles. So, what’s happening exactly?

Remember first how Botox works: it blocks the muscle receptor that is stimulated by the nerve that tells it to contract. Treated muscles stay in a constant state of relaxation, which makes the skin look perfectly smooth instead of wrinkling with contraction (facial expression). Your brain is still telling your muscles to move and they can’t. If certain muscles can’t or won’t move to create facial expressions, others start to take over to get the job done! Bunny lines result from over-activity of the nasalis muscle on both sides of the nose. They usually only appear with a smile, so you won’t see them at rest. They happen when too much Botox has been used or when other facial muscles normally used in facial expression are constantly relaxed.

Filler: It’s no secret that we all lose facial volume as we age. One of the places where these changes can make us look dramatically older is around the mouth. There are many areas that can be injected with dermal fillers here. They include the “white” lip (area between the lip and nose), the vermillion border (the edge of the lip itself) and the lips (or “red” lip). Think of each of these as specific, different pieces of a puzzle that all need to be balanced with each other for it to look complete or right. If one area is out of proportion, the whole thing looks off. That is what’s happened here.

At rest, her lips may look great, but when she smiles, you can see that only the body of the red lip has been treated with filler. Her vermillion border is totally flat. Smiling causes the lip to “stretch” and essentially makes the upper lip look like it’s swollen and “rolled” upward over the teeth. This is not a very natural look.

This picture demonstrates the fact that cosmetic injections can be tricky. There is no one, cookie-cutter approach to any of them, Botox or filler. Your injector needs a trained, skilled and artistic eye that not only sees your natural shape and areas that need improvement, but one that can also judge and mitigate unintended consequences of treatment like the ones discussed here. Your evaluation should include an appraisal of your appearance both at rest and with expression and movement. This is the best way to judge appropriate treatments for you and tweak things that may not look quite right. This takes time, attention to detail and a personalized approach to cosmetic injections. Here at Celibre Medical, we pride ourselves on these things and believe our approach is what gives us an edge over the competition.


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