What makes a face look fake after Botox?


Photo credit: allergen

What makes a face look fake after Botox?

This is a sponsored guest post courtesy of Andres Bustillo, MD FACS

Botox injections are a popular treatment to reduce wrinkles and lines on the face. The treatment blocks the signals your nerves send to your muscles, which prevents the muscles in the area from contracting. The wrinkles will relax and soften, creating a smoother and more youthful appearance.

The common stereotype associated with Botox is that the treatment makes your face look fake or frozen. In most cases, the results of Botox look very natural. People should see that your face looks better, but they shouldn’t be able to tell that you had Botox. An experienced and skilled professional will understand facial aesthetics and anatomy enough to make the treatment look natural. Great doctors will customize the injections by considering your facial muscles, the symmetry or asymmetry of your face, and your cosmetic goals.

Unfortunately, mistakes do sometimes happen. When a face looks fake after Botox, it’s usually because the doctor is inexperienced or made an error. There are a few common errors with Botox treatment, including:

Over-Injected Forehead

If your doctor injects too much Botox into the center of your forehead, it can make your eyebrows look unnatural or exaggerated. An over-injected forehead causes the space between your eyebrows to drop while your outer eyelids lift up. This creates an intense arch, almost like a cartoon villain.

Luckily, it’s usually easy to fix this issue with another Botox treatment. Your doctor can strategically place some small injections that relax the muscles that are pulling the outer portion of your eyebrows up.

photo credit Web MD

Over-Injected Eyes or Crow’s Feet

The forehead is the most popular place to get Botox injections, but lots of people also want to treat the lines around their eyes. Botox can be an effective way to get rid of eye wrinkles or crow’s feet, but over-injecting the area can cause issues. Too much Botox around the eyes will create the classic frozen and expressionless look people associate with the cosmetic treatment, especially when combined with an over-injected forehead.

With this mistake, the upper part of your face may remain completely motionless while you speak. You may be able to smile with your mouth, but your smile won’t reach your eyes or forehead. Some people like this look and hope to achieve it with Botox, but for most people, this is the result of a doctor’s mistake. Your doctor may be able to fix this partially with more injections, but you may have to wait for the Botox to wear off.

Uneven Injections

With uneven injections, one of your eyebrows may arch higher than the other. Imbalanced injections pull the muscles of one eyebrow up and leave the other down, leaving you with a cartoon-like quizzical or skeptical facial expression.

Most people have naturally asymmetrical faces and facial muscles. Your doctor should consider this when determining how much Botox to inject into each side of your face. If you get the same amount of Botox in both sides, it may highlight or exaggerate the asymmetry. A good doctor will observe how your facial muscles work and give the proper amount of Botox to each side, even if each side needs a different amount.

Injection Into the Wrong Muscle

Before giving you any injections, your doctor should observe your face to see which muscles your face uses the most. Then, your doctor can decide which muscles should receive the injections to achieve the desired results.

A common mistake is getting injections into the frontalis muscle, which runs along your forehead and connects to your eyebrows. This can make your forehead relax, which is typically a goal of Botox. However, it also can make the eyebrows relax excessively. This will make your eyes or eyebrows look droopy and heavy and your forehead look ironed out or frozen. Unfortunately, this mistake usually isn’t fixable. You’ll have to wait a few months for the Botox to wear off.

How to Avoid Botox Mistakes

Most causes of a “fake face” after Botox are avoidable. The best way to ensure you get successful, natural-looking Botox is to find a reputable doctor. If any of your friends have gotten a great Botox treatment, ask them who they saw. You can also look online for reviews or recommendations. During your initial consultation with a doctor, ask lots of questions about how long they’ve been practicing and what their process for Botox injections is like. Ask for before and after pictures of their other patients to see whether the results are similar to what you’d like to accomplish.

If you’re considering getting Botox, don’t let pictures of fake or frozen-looking faces deter you. When you get the treatment in moderate amounts from an experienced doctor, you should have good results.

photo credit: NowLoss.com

Andres Bustillo, MD FACS is one of the top facial plastic and reconstructive surgeons in Miami. Dr. Bustillo is a member of the American Board of Facial Plastic and Reconstructive Surgery and the American Board of Otolaryngology- Head and Neck Surgery. He has years of experience performing Botox and a wide variety of other facial cosmetic procedures.


  1. This is great advice, there is nothing worse than over-injected Botox! It’s hard to read expressions, if there really aren’t any! I have never had Botox, but know lots of people who have, and some love it, while others say they won’t do it again.

  2. My cousin’s wife has Botox injections (she’s a nurse too) and she’s done it for several years now. If she hadn’t told me, I never would have known because it looks so natural.

  3. It’s funny that you posted this because just yesterday I said that I was going to look into getting botox in my forehead. I hate that little line and the only thing that seems to help is Olay but if I forget to moisturize, the line shows up.

  4. Good tips! It’s an art form and you have to go to someone good!

  5. Interesting. I always knew there had to be more to it:) I’m actually horrible at recognizing when people have had it done, none that it matters.

  6. Interesting article!

  7. I am so terrified on needles!!! Great post but I am still so scared!!

  8. I think I’d like to try injections eventually – maybe not Botox, rather fillers – but I’m terrified of needles!

  9. Interesting article, not something I’d be interested in though. I’m ok with however gravity decides to work on my face. LOL

  10. I’ve been debating on taking the botox plunge, so this post is quite timely! I haven’t really started the search yet, but finding a reputable doctor with great reviews is very important to me!

  11. This is good information because it does seem as if a lot of people are having it done wrong. It would seem that done well, it can barely be detected, if at all.

  12. Natural enhancement is better. That is what I practice with my own patients

  13. I just saw something on the news about Botox! I heard some have been using it on Children as a way to help kids who have really bad migraines!

  14. I’ve seen good Botox and I’ve seen bad Botox so it’s nice to read more information on it. I have some friends who swear by it and others who swear off it – I think it would be great for me to send BOTH to this article! <3 Thanks for sharing!

  15. This is very informative! It’s definitely best to do your research before any procedure, I know I will when it’s time for me!

  16. I really like how your post was centered around things that could go wrong…many people don’t look at the things they don’t want to hear. You made iit simply and to the point!

  17. Yvette Price says:

    This is a great article! I’m glad to see a doctor backing what could go wrong, have you done research into the non cosmetic uses for botox? (ie: migrants, excessive sweating and muscle spasms)

  18. I think the fake look comes more from surgery than Botox. I would get Botox in a minute!

  19. I’ve thought a lot about botox but haven’t gotten it yet. Good to get these tips though!

  20. I cringe when I see overdone injections. Moving face is a beautiful face 🙂

  21. Ehmkay nails says:

    This definitely isn’t for me right now but this was super informative.

  22. Great to know options like Botox exist – and that when done properly they can be amazing!