I’ve been doing Botox for years. Are there any real risks? | Opinion

Q. I’ve been doing Botox for years, and now it seems like everybody is doing it. Are there risks?

A. Botox has become so common that many people think of it as casually as getting their hair colored. But even though Botox is safe when done properly, it is still a medical procedure. The goal is not simply to “freeze” the face; the goal is to soften lines while keeping the face natural, balanced and expressive.

Most Botox problems are not dangerous. The most common problem is that the patient does not get the result they should have gotten.

Poorly placed Botox can create forehead heaviness, drooping of the brows, strange eyebrow angles (a “Spock” look) or a flat, scary-looking forehead.

Sometimes patients think they suddenly need upper eyelid surgery, when in reality the forehead has been weakened too much and the brows have dropped. Botox can also occasionally cause eyelid drooping, asymmetry, headaches or bruising, although serious reactions are uncommon.

Botox is also used for more than wrinkles. It can help with migraine headaches, excessive sweating, jaw clenching, neck bands, and facial muscle imbalance. In the right hands, it is one of the most useful tools we have in aesthetic medicine.

The key is experience and judgment. The injector must understand facial anatomy, muscle balance, brow position, eyelid function and how one muscle affects another. A good Botox treatment should make you look refreshed, not surprised, angry, heavy, or overdone.

The best way to avoid problems is to choose someone who does not just “do Botox,” but understands the face. Sometimes the right answer is Botox. Sometimes it is filler or surgery. And sometimes the best treatment is doing less.

You want a physician who will recommend what is right for you, not simply what they offer.

Dr. Carlos Wolf is a partner in Miami Plastic Surgery and is board certified. Email questions to him at Cwolf@miamiplasticsurgery.com