Category Archives: Botox Anatomy

Bumps after Botox?

“I have horns!”

Horns right after Botox injections?   I heard this exclamation after a Botox injection today.  And I thought to myself – what a great topic for my Modesto Botox Blog.

They aren’t horns, they are bumps.

Well, that sounds almost as bad.  But these bumps are from the injection of Botox under the skin and sometimes into the muscle (depending on the location of Botox injections).  Botox is reconstituted as a liquid (from a powder), and then injected as a liquid in these locations.  Liquids will naturally take up some space, and they look like little bumps.  Probably a little bit bigger than those TB testing shots that we get from time to time in our forearms.

The bumps usually go away in about 15-30 minutes.

Fortunately the Botox bumps usually go away in a few minutes.  Sometimes by the time a patient drives home.

The Botox bumps I’m discussing in this blog are the ones that can be seen immediately after a Botox injection.  I’m not discussing bumps that occur hours after or days after the Botox injection.

What else could it be?

If these Botox horn or Botox bumps don’t go away, it could be something else like a hematoma.  A hematoma is a collection of blood – from bleeding, which could happen after injections with a needle.   And the collection of blood could cause the bump.  Hematomas will also resolve with time, but ideally, I try to avoid large hematomas by observing the injection site during and after my Botox injections.  Sometimes hematomas can’t be avoided.  But I would try to minimize them.  A smaller Botox needle might help, too.   Hematomas usually will result in bruises which will also resolve.  At least this is what I do in my Modesto Botox Practice.

Below is a picture of me, not a picture of Botox bumps.
Calvin Lee, MD
Calvin Lee, MD

If you haven’t looked directly at my crows feet or glabellar lines – in person and at my office – then we have not established a formal doctor-patient relationship.  Please see your own doctor.  There is no medical advice here, just medical information for general use – nothing here is directed at any specific person.

Botox Vials

Botox Vials


Muscles, Nerves and Vasculature of the face for the Botox and Juvederm injector

These are just some notes – this is by no means complete.  Just sporadic notes to supplement other sources.

Lip elevator muscles

  • Levator labii superioris alaeque nasi – gummy smile muscle.
  • Levator labii superioris
  • Levator anguli oris
  • Zygomaticus Major/minor

Lower Lip depressor muscles

  • Depressor anguli oris
  • Mentalis
  • Depressor labi inferioris

The Frontalis Muscle

  • Creates the transverse rhytids
  • Only elevator of the brow – don’t want to entirely weaken this muscle with neuromodulators (ie. Botox).  Consider limiting the injections to the upper 2/3 of this muscle.
  • Wrinkles are perpendicular to the movement of the muscle.

Agonist/Antagonist action of muscles on the Brow

  • Obicularis Oculi, Procerus, and corrugators depresses the brow vs. Frontalis.  Tug-a-war.  Can change the shape and location of the brow with Botox/neuromodulators.

Parts of the Obiclaris Oculi Muscle

  • Palpebral portion= Pretarsal (lies on tarsal plate) and Preseptal = responsible for passive closure of the eye
  • Orbital portion – further out laterally.  Responsible for forceful closure of the palpebral fissue of eye.  Accessory muscle to smiling.

Nerves of the superior orbit

  • Supratrochlear nerve – runs through the belly of the corrugator supercilii.  This nerve provides sensation to the medial 1/3 of the forehead and is a nerve that can be responsible/trigger for migraine headaches.
  • Supraorbital nerve – just lateral to the supratrochlear nerve.  Sensation for the lateral 2/3 of the forehead.


There is much more, but this is a start.

I have made this super webpage a few years ago with BOTOX muscles of the FACE

That link above may be of interest to you.


Meanwhile feel free to visit our self-made Botox home page:  Modesto Botox by Dr. Calvin Lee, Surgeon.  Thank you for visiting.