What to Do About a Frozen Face After Botox: 15 FAQs Answered

This article is written for people who want Botox but, lacking expert knowledge, keep putting off the decision. On the subject of botulinum toxin, the 15 questions people are most curious about are all answered here!

Q1. What can Botox improve?

Botox mainly improves 4 types of concerns

1. Facial wrinkles: improves forehead lines, crow's feet, frown lines, bunny lines, and more.
2. Facial shape: improves a square jaw (by relaxing the masseter) and provides lifting (using muscle antagonism to improve sagging lines)
3. Body shape: improves "radish legs" (slimming the calf muscles) and "buffalo shoulders" (relaxing the trapezius)
4. Hyperhidrosis: improves underarm odor and sweaty palms.

Q2. Can botulinum toxin improve all wrinkles?

Facial wrinkles fall into two types: dynamic and static.

Dynamic wrinkles are lines created by muscle contraction, such as forehead lines, frown lines, and crow's feet. Static wrinkles form from skin aging, loss of elasticity, and laxity, such as nasolabial folds and marionette lines.

Botulinum toxin acts mainly on muscles, relaxing muscles that were overly tense and contracted, so it can only improve most dynamic wrinkles.

Q3. Who should not get Botox?

Botulinum toxin is not recommended for people with myasthenia gravis, during pregnancy or breastfeeding, with an infection at the injection site, or shortly before a major event.

Q4. What is the Botox injection process?

After the injection sites are confirmed, the physician assesses the dose to use. Applying numbing cream and then icing for a few minutes is recommended, since it lowers the pain of the injection. Treatment time depends on muscle size and the area treated, and is usually done within 5-10 minutes on average.

Q5. Are there risks in Botox injections?

Complications from botulinum toxin injections are rare. Discomfort is usually caused by a physician's lack of solid skill, incorrect aftercare, or the wrong dose.

An expert physician can avoid the above, but headaches and flu-like symptoms may still occur within 24 hours of injection, or bruising and swelling may appear around the injection site. If the injection area is around the eyes, in the worst case blurred or double vision may occur.

If any of the above occurs, it generally lasts about 1-4 weeks and can be relieved with treatment from the physician, so having the injection done by a licensed, professional physician gives you better protection.

Q6. Why do some people end up with a stiff, fake "plastic face" after Botox?

Some people worry that muscles will stiffen after Botox, making facial expressions unnatural. This is mostly caused by these 5 reasons:

1. Botox placed in the wrong spot

If the injection site is off, it not only affects the result but can also cause damage that makes facial expressions stiff. However, botulinum toxin only relaxes the muscle temporarily and does not cause permanent damage.

2. Botox injected too superficially

If the physician injects Botox into the upper layer of the muscle, facial nerves may be damaged, making the face stiff. Common signs include drooling and a crooked mouth.

3. Too much Botox

More is not necessarily more effective. Some people assume deeper wrinkles need more Botox, but too much leaves the whole sheet of facial muscle unable to exert force, causing stiffness. For the face, it is recommended not to inject more than 100 U in one session.

4. Too short an interval between two Botox injections

As a rule, an interval of at least 4-6 months is recommended, and a second Botox injection after 6 months is the safest.

5. Massaging the injection site after Botox, causing it to spread

Never massage after Botox! Massage lets the toxin seep into nearby muscles, causing unnatural expressions.

Q7. What if my face is already stiff?

Botox is gradually metabolized by the body, though the rate differs from person to person. Generally, it returns to normal within 3 months. To speed recovery, exercising the muscles at the injection site or chewing more can shorten the recovery time.

Q8. How soon will I see results after Botox?

For facial wrinkles, results are visible in about 3-7 days, with clear improvement of wrinkles after 2 weeks.

For a slimmer face, clear results appear in about 1 month. A dry mouth and weak masseter muscles are normal, and during this period you should avoid overusing the masseter.

For radish legs, because the leg muscles are larger, it takes 1-2 months to see results. After treatment, you may feel leg weakness and soreness or numbness when climbing stairs, which gradually recovers after about 1 month.

Q9. How long does botulinum toxin last?

Botulinum toxin is gradually metabolized by the body, and how long the effect lasts depends mainly on individual constitution. To maintain the effect, re-injection is needed about every 4-6 months on average.

Q10. Is it true that too much Botox stops working? Are there other side effects?

Botulinum toxin is a naturally derived purified protein that the body absorbs easily, so drug poisoning and allergic reactions are less likely. Unlike laser, Botox cannot be done every month: the more frequent the injections, the more easily the body develops antibodies, and once antibodies form, the effect of later injections drops sharply.

Generally, an interval of about 6 months between injections is the safest, and 2-3 times a year is enough. Current Botox treatment has no permanent side effects. Most discomfort that occurs improves and is adapted to within a short time.

Q11. How many units can be injected at once?

The physician assesses your individual situation, and the dose is also related to the area. In general, a facial wrinkle area takes about 8-16 U, a slimmer face about 40-50 U, slimmer calves roughly 160-200 U, and hyperhidrosis about 50-100 U per area.

Q12. Why do botulinum toxin prices on the market vary so much?

Before opening, botulinum toxin is a vacuum-dried powder that must be diluted with saline before use. If the concentration is halved, not only is the effect halved, but its duration is also shorter. This is why low-priced botulinum toxin exists, so always confirm the number of units with your physician before injection.

Q13. What details should I pay attention to in a botulinum toxin consultation?

During the consultation, clearly tell the physician the results you expect, and also share your medical history and whether you are allergic to drugs or proteins. You should also know which brand is used for your Botox treatment, since it affects both efficacy and price, so that the results do not fall short of expectations after injection. (Read more: 4 Major Botox Brands Compared! Pros, Cons, Prices, and Results at a Glance) (this article)

Q14. What should I watch out for after the treatment?

Do not touch the injection site for 4 hours, and do not wash your face or apply makeup. Most importantly, do not lie down, to avoid the toxin spreading to the surrounding muscles. For one week, no facial massage, hot compresses, rubbing, or eating hard-shelled foods.

Q15. If I stop after having Botox, will the muscles get bigger and the wrinkles more obvious?

No! Botulinum toxin lets muscles rest and relax temporarily. Even if you don't get it again, at most you just return to how you were before. It will not make muscles bigger or wrinkles more obvious.