How to Avoid a Bad Botox Experience

Dr Mark Aszkenasy
By Dr Mark Aszkenasy

Dr Mark has been providing aesthetic beauty treatments since 2011.


Botulinum toxin (Botox, produced by Allergan, is the most commonly used form of the medication) is a powerful drug. When given by an expert it can take years off your appearance, and used correctly you will be able to retain a natural look.

However, in some countries regulation of who can provide Botox is not very strict and you may find that you have a bad Botox experience.

So what is a bad Botox experience and how can you avoid it?

You can have a bad botox experience if you are given too much or too little Botox, if it’s given in the wrong place, or if your provider is inadequately trained or is unscrupulous and using something other than one of the regulated forms of Botulinum Toxin (the main ones at the time of writing are Botox, Azzalure (Dysport in the United States), and Bocouture (Xeomin in the United States).

How to avoid a bad Botox experience

You can tell if you’ve had a bad Botox experience if one of the following has happened after your treatment:

  • Drooping of one eyelid, which means that your provider may have given the botox too close to your eyelid muscle. Having said that, other factors can lead to the migration of botox into the eyelid muscles, such as having a facial or lying down after Botox or vigorous exercise immediately after Botox
  • Drooping of both eyebrows (feels like you are looking out under the peak of a baseball cap). This usually means that your Botox provider hasn’t properly evaluated your forehead musculature and given the Botox too low down or has been too aggressive dosage or a combination of the two.
  • Completely frozen expression (unless, of course, you specifically requested it, some people do like this look!) which suggests that you might have had too much botox.
  • Drooping one side of the face. The botox has probably been given too close to the cheek muscles.
  • Inability to close your mouth properly. Too much botox has probably been given into your lip muscles when trying to treat those upper lip lines and wrinkles.
  • Coice hoarseness or difficulty in swallowing. This is a potentially serious complication that can occur after Botox treatment in the neck. If you get this seek medical advice immediately.

So how can you reduce the chance of having a bad botox experience? The answer is to choose your Botox provider with care.

Ask the following questions:

  1. What is their training, experience, accreditation and qualifications? They should have been trained by an accredited Botox trainer. They should be thoroughly experienced in doing Botox injections and have an adequate number of patients each week with which to maintain their skills (ask them how many patients they treat in an average week if it’s less than four or five you should be concerned).
  2. Ask your provider what their complication rate is. Anyone doing regular Botox will experience occasional complications. If they are a UK doctor then they should know as one of the requirements of medical appraisal is an audit. If they say they never have any complications then either they are not seeing enough patients or they are not being truthful and you should consider changing your provider.
  3. Ask them what their ongoing supervision and validation requirements are. As part of medical quality control (known in England as clinical governance), All UK doctors and nurses have to have strict annual appraisal requirements where the quality of their work is reviewed by an external expert.
  4. Ask them which brand of Botulinum Toxin they use. All of the major brands (Botox, Azzalure (Dysport) and Bocouture (Xeomin) work just as well as each other if given in the correct strength, but one unit of Azzalure does not equal one unit of Bocouture or one unit of Botox. Around two and a half to three times as many Azzalure units need to be used for every unit of Botox or Bocouture. So if your provider uses Azzalure ask them how many units they use for their treatment.
Things to avoid a negative Botox experience

So you can see there are major advantages to choosing a fully registered doctor, dentist, or nurse to provide your Botulinum Toxin treatment.

It guarantees quality assurance in terms of knowledge, training, ongoing experience and appraisal as this is needed to maintain registration and validation to provide medical cosmetic treatment.

If you want to read more, the experts at Consulting Room really know what they're talking about and have put together Botulinum Toxin, Botox, Azzalure, Dysport, Bocouture, Xeomin and also lines and wrinkles FAQs just for you. 

If you have more questions, you can use the Botulinum Toxin, Botox, Azzalure, Dysport, Bocouture, Xeomin and also lines and wrinkles questions feature to talk to our panel of trained medical experts. 

If you're keen to get started with any of these treatments right away then you're in luck - those clever folks also have a list of trusted, accredited Botulinum Toxin, Botox, Azzalure, Dysport, Bocouture, Xeomin and also line and wrinkle clinics in your area.

Many thanks to the author of this blog Dr Mark Aszkenas who has been providing aesthetic beauty treatments since 2011.

He is a consultant in the National Health Service and has the diploma of the membership of the Royal College of Physicians.

Dr Mark saw the need for a simple and effective range of skincare treatments, containing ingredients at a strength that could achieve results, and launched the Dr Mark Skincare range.

Thanks to the author

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