If you look at her cheek (our left her right) - it looks like she was shot in the face back in the day... or is that some form of paralysis.
I did a Google search and got this commentary from a medical referral site:
It was reported in the last two issues of Plastic and Reconstructive Surgery the Botox injections caused prolonged paralysis of the entire side of one woman's face and the drooping of the lower and upper lid of another woman.
Who knows?