Injectable Warning: Cookie Cutter Injectors Could be Ruining your Beautiful Face

I have been thinking about this a lot lately. I seem to keep seeing the same faces over and over on Facebook, Instagram and in public... frozen foreheads, broad noses from too much botox, overfilled cheeks, and lips that do not fit the rest of the facial features. What is going on? I am beginning to wonder if injectors are aging people and taking beautiful faces and making them look like the same faces over and over. Here are my thoughts about why this is happening and what to look out for
As a trainer for Allergan, known as an ACE Traininer, I first began to notice this phenomenon at my own conferences that I was attended, filled with the top injectors (including Physicians, PAs, NPs, RNs).  As I was people watching, I kept seeing the same features over and over and wondered what was going on.  Well, it only makes sense that if we are doing it to our own faces, the same would hold true for patients.  Of course, there are so many skilled injectors out there who do not create such looks but many do.  Here are my top 5 NO NOs:
  1. Shiny, frozen foreheads:  The forehead is the only elevator in the upper face and many people complain about forehead lines with unrealistic expectations... NO movement.  So, what happens?  The frontalis is over treated with toxin creating a brow ptosis (heavy brows), diminishing the arch and masculinizing the face.
  2. Brows that are pulled too far apart in the center with Captain Spock peaks laterally.  This is usually a look created by a newbie who is over treating the glabellar complex (muscles in between brow) and the medial forehead area.  It also makes the bridge of the nose look wider and the eyes look smaller.  A dead give away that you have botox and an unskilled injector (Groupon anyone???).
  3. Frozen upper face with exaggerated movement in lower face.  Many injectors forget to use a pan facial approach to softening muscle movement with both the upper and lower face.  A little bit of neurotoxin in the chin, DAOs and perhaps lip lines can be a wonderful softening for an overall nice look.  The problem?  Once again it is the unskilled injector who often is only focused on the upper face with much too much toxin and nothing in the other half.
  4. Over filled lips.  We have all seen it and shockingly, many people want the look.  There is a fine balance, however, between giving you a full lip that looks proportioned to your face and giving you a look where you lips enter the room before you do.  Your injector should look at all of your features and create either a subtle or plump lip that fits your face.  It is also important how the filler is injected to avoid a 'joker mouth' when the corners are turned up too high and also a 'duck lip' when the lip sticks out.
  5. Cheeks for days.  We have gone to the extreme now.  Many injectors used to fill lines and not cheeks, which did not look right.  Now we focus on cheeks and forget to assess all of the face to created softness and proportions.  This includes looking at the temples, fat pads in front of the ear area, lower face and cheeks.  Many providers over inject the cheeks, often medially, and cause the rest of the face to look off.  With such injections, often the lateral face is flattened, the temples are sunken and the eyes to look smaller.
So, when you make an appointment to see your Injector, make sure they really do have an art for injecting.  They should be looking at your face, having you animate, and creating a plan that fits your individual facial features.  Remember it is about softening lines, gentle lifting and volumizing the face and allowing you to look refreshed and natural.  You want to see a provider who injects all the time, has great reviews and looks natural themselves.  If they look over filled or frozen, chances are you will come out looking the same way.