What Happens When Botox is Injected Too Deeply?

When it comes to Botox injections, the depth of the injection is just as important as the amount of toxin used. If the injection is given too quickly or too deep, excessive swelling and bruising may occur. Bruising is especially common if the injector hits a vein or pushes too hard. While this is a temporary side effect, the patient will be forced to live with an unsightly hematoma for days, if not weeks.

Injecting botulinum toxin too deeply is a common mistake, but so is injecting it too superficially. This problem is most often observed when targeting the masseter muscle near the mouth, which is responsible for chewing. If the toxin is not administered deep enough, the risorium muscle may be affected, resulting in an uneven smile. Even if the masseter muscle is reached, the lack of deep enough injection can cause the lower parts of the muscle to move normally while the upper part is relaxed, creating a “squirrel” appearance.

Doctors should try to inject at the site where the muscle attaches to the bone, using a ½ longer needle for best results. One of the most common mistakes untrained professionals make is not injecting Botox deep enough or injecting it too superficially. Botox should be injected into the superficial layers of the skin in some areas, while in others, it must be injected deeply. An example is the masseter muscle near the mouth. If a doctor does not inject this muscle deep enough, patients may end up with an uneven or unbalanced smile. That's why it's so important to choose a clinic with excellent safety standards and trained staff who know how deep botox should be injected.

Drooling and speech interference for these types of injections are almost always associated with excessive doses and volumes when treating this area. Without a doubt, Botox or botulinum toxin holds the title of the most demanded non-surgical cosmetic procedure in the world. As mentioned above, you should not inject Botox into the cheeks because it will affect the movement of the zygomatic muscle that raises the corners and upper lip. A similar situation may occur if orbicularis oris is injected instead of the intended depressive septum, and some patients are unable to properly move the upper lip if this occurs. Studies have been done that show that superficial injection of Botox into the forehead, as you describe, is just as effective as deeper injections.

Trained doctors used medically approved fine needles that are similar in thickness to what type 1 diabetics use every day when injecting themselves. Therefore, it's essential for doctors to understand where each muscle attaches to bone and how deep they need to inject Botox in order to achieve optimal results. They will use this knowledge to judge the location of the muscle where the Botox injection will go and the depth to which the needle should be inserted. The above article is a guide that will help you better understand the areas of adhesion and need to correctly position your needle when administering Botox injections. This guide should help expand your standard of care and thus improve patient care for these popular procedures. For example, in patients with a long forehead, two rows of injections may be required to cover the area sufficiently. This condition can be avoided by not performing injections under the eye into the orbicular muscle of the eye and usually affects elderly patients due to their laxity of this muscle under their eyes.

The only risk that is different when injecting Botox into wrinkles under eyes is that injectors must be very careful with dosage, placement and selection of right candidate. And although I am personally still hesitant about going under needle myself, at least I can effectively argue with my husband that Botox is safe for his body.

Lily Cautillo
Lily Cautillo

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