SkillHouse

Just saw this in an online group. Gawin natin itong case study para may matutunan tayo.

What we know (based sa comments ni author):

• After niya magpa-Botox sa crow’s feet, mas naging obvious yung crease
• Nagpa-undereye filler siya 1 year ago
• Very obvious daw kapag siya ay nags-smile
• Hindi niya alam ang gagawin 😅
• At syempre… ang daming opinions 😅

Let’s break it down:

1. Most likely this is a dynamic malar fold
This could be due to underlying midface imbalance. Meaning, possible na may effect pa yung old filler plus muscle dynamics, na mas naging visible after the recent Botox sa kanyang orbicularis oculi.

2. Fillers can still be present
HA fillers can last 12–18 months, especially sa low-movement areas like undereye. So possible na nandiyan pa siya, either slightly shifted or fixed, habang nag-age na yung surrounding tissue.
Result: relatively full upper zone

3. Imbalance creates a transition zone
If supported ang upper area pero kulang ang support ng midface, magkakaroon ng visible transition.
• Often due to aging, mild fat pad descent, and volume loss

4. Bakit mas obvious kapag nags-smile?
Smiling activates the zygomatic muscles, lifting the cheeks upward.
The skin then compresses sa areas of least resistance — kaya lumalabas yung fold.
• Ibig sabihin, this is dynamic, not purely structural

5. Bakit lumala after Botox?
Recent crow’s feet Botox, especially if medyo mataas ang dose can weaken the lateral orbicularis oculi.
• Reduces lateral cheek support
• Alters muscle balance
• Causes redistribution of movement during smiling
• Makes pre-existing imbalance more visible

So what’s the next step?

• Proper assessment muna, always aim for overall facial balance
• If may excess or migrated old filler, i-dissolve muna
• Restore midface volume and support
• Do subtle touch-ups to blend the transition zone, wag mag-overfill!
• Next time: assess properly before injecting then avoid over-weakening the orbicularis oculi
• Also consider adjunct treatments like RF or HIFU

Takeaway:

Hindi lahat ng lumalabas after Botox is "Botox Fail".
Minsan, it reveals an existing imbalance that was already there.
Tapos attend kana ng training namin para mas gumaling ka pa!😆

CTTO

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If you’re performing Botox treatments on the frontalis, precision in identifying the correct muscle is non-negotiable.

We’ve just uploaded a highly accurate, clinically reliable anatomical illustration of the frontalis—clean, detailed, and ideal for proper injection planning.

Important:
Not all illustrations found online are accurate. Relying on incorrect anatomy can easily lead to avoidable complications.

Use this image as your anatomical reference when mapping your injection points.
Key reminders:

✅ The frontalis is the only true elevator of the brows
✅ Improper injection placement can result in brow ptosis or asymmetry
✅ Always follow the natural fiber direction and respect anatomical borders

Review the image carefully to help ensure safer treatments and more consistent, predictable outcomes for your clients.

Stay precise. Stay conservative!

Still not aware that the Deep Inferior Tendon (DIT) can cause Botox complications like Paradoxical Masseteric Bulging? 🤔 Maybe it’s time to join one of our online courses! 💉

𝗞𝗻𝗼𝘄 𝘁𝗵𝗲 𝗥𝗶𝘀𝗸𝘀 𝗕𝗲𝗳𝗼𝗿𝗲 𝗬𝗼𝘂 𝗜𝗻𝗷𝗲𝗰𝘁: 𝗧𝗶𝗿𝘇𝗲𝗽𝗮𝘁𝗶𝗱𝗲’𝘀 𝗪𝗼𝗿𝘀𝘁 𝗔𝗱𝘃𝗲𝗿𝘀𝗲 𝗥𝗲𝗮𝗰𝘁𝗶𝗼𝗻𝘀

Tirzepatide (Mounjaro / Zepbound) is one of today’s most powerful medications for weight management and Type 2 diabetes — but with its benefits come serious potential risks that every injector must understand.

While most patients experience only mild GI symptoms, there are rare but life-threatening adverse reactions practitioners should always screen for and monitor.

Reminder:
Always perform a thorough medical history, check for contraindications, educate your patient, and monitor closely — especially during dose titration.

Safety should never be compromised for results.
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