Botox pictures- Does She or Doesn’t She, and How You Can Tell!

August 21, 2012

Case Studies

Botox is far and away the most popular cosmetic procedure done in the world. Millions of people get these injections every year. Have you ever looked at someone, a celebrity, or just a lady of a certain age walking down the street, and wondered “Does she or doesn’t she?” Well look no further! Here are some real, untouched photos of the effects that Botox injections can have on different areas of the face. We will discuss telltale signs of Botox use, and how you can tell good Botox from bad Botox injections. Before we get started, let’s cover some basics.


Where Botox is Used, and How it Works

Because Botox works by relaxing the muscles, it works best on the lines of the face that are caused by muscular contractions: namely the lines of the forehead, between the brows, and around the eyes. Typically, the lines of the lower face are caused by volume loss instead of muscle movement, and have to be treated with fillers or lasers. Botox can also be used for some work on the lower face, but it is less common and the results are less dramatic.

You can think of the face is a series of pulleys. Some muscles pull the face upwards, some muscles pull it downward, and some muscles pull to the side. If you relax one muscle-for example a muscle which is responsible pulling part of face upwards – whatever area the face you are working on will move downwards. If you paralyze only a muscle that is pulling down, the effect is reversed and that area of the face will move up. For example, Botox is often used to do “brow lifts”. Botox cannot actually lift a brow, since all it can do is relax muscles, however, by relaxing the muscles that hold the brow down, the brow can in fact be lifted. The same is true for the corners of the mouth. As we age, the corners of our mouth tend to droop. Botox use in the muscles which are pulling the corners of the mouth down, can lead to a “lift” at the corners of the mouth.


Botox in the Forehead – Dead Giveaway Number One

The parallel lines in the forehead are caused by the action of the Frontalis muscle – a flat band of muscles that cover the entire forehead, and down into the temples. Botox is used to relax this muscle, leading to smoothing of the lines across the forehead. This typically costs between $120 and $200 depending on the depth of the lines.

The pitfall of this type of injection is one of the most common giveaways signs that someone has done Botox. The frontalis muscle, the muscle which covers the front of the four head, is the main muscle responsible for holding your eyebrows up. If the whole frontalis muscle is completely relaxed, the brow will drop down, leading to “hooding” of the eyes, and a tired look. Since people get Botox injections in order to look younger, and more refreshed, this look is very undesirable. Therefore, most injectors will avoid the sides of the frontalis muscle, so that the corners of the eyebrow will still be held up. However, when you do this, you create “horns” which is known in medical circles as “the Mephisto sign”, and the easiest way to tell if someone has had Botox or not.

In the picture on the right you can see that the Botox was not placed all the way across this patient’s forehead, and she still has the ability to raise the corners of her forehead, leading to wrinkles only on the outside edges.

Another common sign of Botox in the forehead is what we call “the Spock look”. Botox is often used to try to create a brow lift, however, when you lift the brow too much, people can end up looking… Well… Like Dr. Spock. It’s the eyebrow can be lifted too far the forehead, giving the patient a permanently surprised look. In this pictures of Kate Gosselin to the left you can see this effect.

When Botox is well done, however, neither of these signs will be visible. Bad Botox is easy to spot. Good Botox is always virtually invisible.




 Botox between the Brows – Dead Giveaway Number Two

The vertical lines between the eyebrows are caused by the action of the Procerus and Corrugator muscles – a wing of strong muscles that begin in the middle of the brow and flare out along the eyebrows. You can clearly see these muscle – they are underneath the skin that moves above your eyebrows when you frown. These are stronger muscles than those in the forehead – and even though it is a smaller area, a larger dose of Botox is needed to relax them. This will typically cost between $200-$300 a treatment.

There are telltale signs for this kind of work as well. Often, when one area of the body is weakened, other areas of the body will try to compensate by working harder. This is true when someone loses a limb, or in an increased sense of smell in people who go blind. In the face, when the muscles of the forehead are paralyzed, the muscles of the nose often try to jump in and work harder. Now, you are probably saying, “I did not know that my nose had muscles”. Oh it does! There are muscles that run along the top and the sides of the nose, that allow you to “scrunch” your nose. In individuals who have had Botox, these “bunny lines” become much more visible when the individual smiles. In the picture of Nicole Kidman you can see a clear example of this type of reaction.

However, those clever plastic surgeons have a fix for this one too. If a person develops bunny lines after injection with Botox, you can simply put a small amount of Botox in the nasalis, the muscle which controls the sides of the nose, and the bunny lines will go away.


Botox for Crows Feet – Dead Giveaway Number Three

The lines that form around your eyes when you smile are caused by the Orbis Occularis muscle – a circular ruing of muscle that circles the entire eye socket. This is a small flat muscle, that is relatively weak. The average cost is between $150 and $250 depending on the depth of the lines. This is usually an easy one to spot. If a person smiles, and the corners of their eye does not “crinkle” that is a good sign that they have had Botox in this muscle. However, if you use slightly smaller doses of Botox, slightly further away from the eye, you can preserve the crinkling just around the eye itself, while only removing the lines which radiate outwards towards the temple. If the Botox is done in this way, there’s no real way to tell.




 Botox around the Mouth – Dead Giveaway Number Four

The vertical lines that run across the top lip are called smokers lines – even in people who do not smoke. Botox can soften them be relaxing the circular muscle around the mouth. This typically costs between $50-$80.

Botox around the mouth can be difficult to spot, because the effects are often very subtle. However, when too much is put in, patient can often have difficulty pursing their lips, and will be unable to use a straw without dripping water all over themselves. This degree of relaxation of the muscle, however, is rare.


Botox in the Jawline – A Not-So-Easy to Spot Change

Botox can be used to slim the jawline in some individuals. This can take a square jaw, and turn it into a smooth oval shape without surgery. The good news about this technique is twofold – it typically lasts 6 months (instead of the usual 3). Also, since it is relaxing the muscles that typically cause TMJ and tooth grinding, it can reduce the symptoms from those as well.

This is one of my favorite Botox techniques, because it can have such a profound effect on the patient’s overall face. Classically, the female face should be oval or an inverted triangle. The square jaw is a much more masculine look, and Botox can reverse this without surgery, with one 10 min. long treatment. I feel that this technique is profoundly underutilized, since the results are just as good as any jaw slimming surgery I have ever seen, without scalpels, scars, or all the other risks that go along with it. The only sign to tell if someone has had this type of Botox done is a gradual change the shape of face to more feminine configuration. Since this happens so slowly (over approximately 6 months), it is very difficult to detect, even for professional.



When Botox is applied with too heavy of a hand, there can be many signs that even the non-medical can notice. Among these, are lines in the corners of the eyebrows, bunny lines, or inability to move the eyes in order to smile naturally. However, when Botox is injected skillfully, these signs can be difficult or impossible to see. Botox well done, remains, the fastest, simplest, and best way to take 10 years off your face and 10 min.

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2 Responses to “Botox pictures- Does She or Doesn’t She, and How You Can Tell!”

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