This is my first time using Botox. Is this normal?

Dr. Dean Kane Q & A.

Q.  I just had Botox for the first time. I am 37 with minimal wrinkles. I wanted to try Botox in the "crows feet" area and asked if it would help with slight wrinkling under my eyes when I smile. Injector asked me to smile, made a couple of marks and injected me 3x below each eye (25 units) and said "you're done". She didn't inject anywhere near the "crows feet" area and I'm wondering if my injection site is normal?
A. Botox is a muscle relaxer which when injected properly will help many but not all active (directly created by a muscle) lines and creases.
​Crows feet are the radiating lines created by the thin, circular muscle (called the orbicularis oculi) under the skin surrounding the upper and lower eyelids, upper nose, brow, lateral orbit and onto the upper cheek. Since this muscle attaches to the inner corner of the eye next to the nose (called the inner canthus), it contracts and:

1. Closes the eye,
2. Pulls the brow inward and downward,
3. ​Creates lines radiating from the inner canthus onto the nose,
4. ​Creates lines radiating from the outer eye called crows feet
5. Will lift the upper cheek

When properly injected along the outer radiating lines, Botox will relax the downward pull of the outer brow allowing it to raise and soften the crows feet.
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​If placed under the 4:00 position of the left eye, or 8:00 position of the right eye, side-effects due to relaxation of the orbicularis and other muscles in this area include:

1. Creation of swelling and fat bags
2. Rounding of the lower eyelid margin
3. ​Loss of ability to drain tears
4. Passive lowering of the upper cheek
5. ​Possible drop in the upper lip

Botox or like muscle relaxers are science and art.
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​It is best to discuss your concerns with your injector. You may also consider a second opinion from a well experienced, Board Certified Plastic Surgeon, ENT Facial Surgeon, Dermatologist or Ophthalmologist.
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​I hope this was helpful.
All the best!

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