Botox, Dysport, Daxxify, and other neuromodulators are some of the most widely used aesthetic treatments in the world, but they’re also some of the most misunderstood. Many people who “don’t like Botox” aren’t actually unhappy with the product itself. Instead, they’ve experienced poor technique or inaccurate placement from an inexperienced injector.
Here’s a closer look at the most common Botox mishaps we see, why they happen, and how to avoid them.
When Botox Causes a “Shelf” Around the Eyes
The Problem
One of the most frequent concerns we hear is about Botox in the crow’s feet area. Instead of smooth, natural-looking eyes, some patients notice their cheeks bunch up or flatten when they smile, creating a “shelf” effect.
Why It Happens
When the lower portion of the crow’s feet is over-treated, the cheek loses its ability to lift naturally with facial expression. The muscle can’t contract the way it should, which causes the skin above it to push upward and form an unnatural ledge.
The Fix
A skilled injector will use lighter dosing in the lower part of the crow’s feet, allowing for some natural movement while still softening lines. In some cases, combining Botox with skin-strengthening treatments, like microneedling or lasers can improve elasticity and reduce wrinkles without risking a shelf effect.
When Masseter, DAO, or Chin Botox Causes a Crooked Smile
The Problem
Botox for the jawline, chin, or DAO (depressor anguli oris) muscles can occasionally leave patients with a crooked or narrowed smile.
Why It Happens
The facial muscles are interconnected. When injecting the masseter muscle, an inexperienced injector can accidentally affect the risorius muscle, which is responsible for widening your smile. Similarly, in the chin or DAO area, the depressor labii inferioris (DLI) muscle can be unintentionally impacted, making the lower lip appear uneven.
The Fix
Avoiding this mishap requires precise anatomical knowledge and correct placement. Staying away from the risorius when treating the masseters, and understanding the depth and location of the DLI, helps minimize risk. If asymmetry does occur, it can often be corrected with an additional unit on the unaffected side to restore balance while the original Botox wears off naturally.
When Forehead Botox Leaves Brows Heavy or Creates “Spock Brows”
The Problem
Some people experience heavy brows or exaggeratedly high “Spock brows” after forehead Botox.
Why It Happens
Heavy brows occur when too much Botox is placed in the forehead or the wrong area is targeted, leaving the brow depressor muscles unopposed. “Spock brows” happen when there’s too little Botox in the lateral brow area, causing the sides of the forehead to work harder and the ends of the brows to arch unnaturally.
The Fix
Adjusting placement and dosing is key. A skilled injector understands the interplay between the forehead muscles and brows. In rare cases, some patients are simply very sensitive to forehead treatments and will always feel heaviness even at low doses. But most of the time, this issue is easy to prevent or correct with proper dosing and follow-up treatment.
Why Technique and Personalization Matter
Botox is not a one-size-fits-all treatment. Every face is unique, with different muscle strengths, insertion points, and expressions. That’s why successful Botox treatments rely on:
- Thorough anatomical knowledge
- Tailored dosing based on individual muscle movement
- Respect for natural facial expression
When these principles are followed, Botox looks subtle, natural, and enhances your appearance rather than freezing it.
Multi-Modality for the Best Results
While Botox is great for reducing dynamic wrinkles, it can’t address volume loss, collagen depletion, or skin quality on its own. Pairing neurotoxin treatments with fillers, biostimulators, and skin-strengthening treatments like microneedling or lasers helps maintain balanced, youthful features over time.
Bad Technique Doesn’t Mean Bad Botox
Most “bad Botox” results aren’t caused by the product itself, they’re caused by technique. By choosing an experienced injector who understands facial anatomy and dosing strategy, you can avoid the most common mishaps and enjoy natural, flattering results. And if you’ve had a Botox experience you didn’t love, don’t give up, chances are it can be corrected with the right approach.
Book a consultation today if you’re ready to find out what Botox could look like when done correctly!
