Facial Laxity after Botox.

I do agree that a Bell's Palsy would be very unusual, though possible.  From your description, it appears that some of the Botox got into the facial muscles that elevate the mouth and cheek instead of purely into the Orbicularis Occuli muscle that is responsible for the crow's feet. Although this is an unusual problem, if this is what happened, you should expect that it will resolve as the Botox wears off.  This usually takes about 3-6 months.  Since it is impossible to be more specific here, I would suggest you see a Plastic Surgeon with significant experience in facial problems so that a complete examination could, perhaps, reveal more.

Botox Injection

Although you have, with the asymmetry, more than a simple tuberous breast deformity, it is highly unlikely that any insurance company will pay for correction.  The only deformity any company I know of will pay for correcting is Poland's syndrome (a severe underdevelopment of one breast) and many will not pay for correcting even this.  I would suggest that you do one of two things.  First, you could start a bank account and treat it like rent or a house or car payment, putting as much as you believe you can into the account each payday until you have enough to pay for the surgery.  Secondly, many Plastic Surgery offices offer financing.  The most common is Care Credit (at CareCredit.com).

Best wishes for obtaining the correction you wish.

Breast Augmentation

Although in facelifts and neck lifts we try and put scars where they are all but invisible, without hair or a beard it is impossible to hide all the scars and still get any significant improvement in the face and neck.  Probably the most reasonable method is a modification of the MACS Lift. Since this pulls almost straight up, there is minimal scar behind the ear (absolutely necessary in other methods) and the scar in the temple is small.  However, this latter scar is still necessary to elevate the face and neck.  It does, however, usually heal quite well.  Only you can decide if this is acceptable.

Facelift

Treatment of Hyperpigmentation

There are multiple ways to treat your problem.  However, I would avoid any Peel or Laser procedure in your case, as you have already demonstrated that you tend to hyperpigment.  I never use either of these without pre-treating the skin to control the pigment.  My first choice would be the use of creams.  If the right ones are used properly, they always work.  These are the same that I would use prior to Laser or Peel.  The only other option I would consider would be IPL, with very controlled wave length, however, I would be very cautious in your case.

Skin Resurfacing

It is definitely possible that, with weight loss, you may not need a breast reduction other than for cosmetic reasons.  Additionally, at a BMI of over 32, you have a significant reason to lose weight.  If you continue with this weight, you will have significant medical problems in the future.  At your present age and with weight loss you can avoid these.  Greater than 90% of weight loss is diet.  At about 40 pounds overweight, you are exercising significantly every day just carrying that extra weight around, and, yet, you are not losing weight.  It is best to make one small change with each meal, like putting slightly less sugar in your tea each time you drink it or using slightly less sugar in a recipe each time you make it, rather than going on a diet and changing what you eat all at once.  This way you get used to the change and won't bounce back to where you were.  The other reason for waiting is that you can get your body to a healthy shape and then match your breasts to your new body if your breasts do not shrink with the rest of you.  Read Dr. Oz's book, "You on a Diet" for information about what is important.

Breast Reduction