If too much botox is injected can it make your eyebrow drop?

You hear about it all the time. Someone overdoes it with botox and they end up looking horrible. I am of the mindset that everything should be done in moderation. Two of my best friends recently got botox injections in their forehead, and I am considering following suit. One of my friends looks great, the other looks OK I guess. But her one eyebrow is sort of dropped. I’m hoping for her sake that it goes away. Is that common or is because the doctor injected too much?

janicee

F, 40, Virginia

If the eyebrow has dropped after a Botox treatment, the most likely cause is too strong of a Botox treatment to the forehead horizontal lines. The good news is it will resolve in 6 to 12 weeks, and sometimes after 2 weeks. Also, there is a technique that may raise the eyebrow that can be performed at 2 weeks after the first Botox treatment.

When you see your injector make sure to them that you don't want a droopy brow and that will key them into not over treating your horizontal forehead lines.


Ken Oleszek, MD

La Fontaine Aesthetics

Denver, Colorado



Couple of things to understand about Botox injections to the forehead:

  1. Botox weakens muscles. If you significantly inject the frontalis (forehead muscle that raises the brows when you are surprised), the forehead will generally rest a little lower and it can make the brows look a bit droopy. Sometimes we minimize this by not injecting for about 1cm above the eyebrows and/or leaving a portion of the lateral outer part of the muscle untreated to create some brow arching.
  2. Brow ptosis (descent of the brow) should be distinguished from EYELID ptosis. The brow coming down slightly is not uncommon and should be discussed as a trade off for getting the horizontal lines substantially reduced. However, EYELID droopiness, which is what you may be concerned about, is considered a complication of Botox and may occur when the product is injected a little close to the eyelid muscles or if it migrates from the injection point(s). For this reason I prefer Botox over Dysport, as Botox is less likely to migrate. If eyelid droopiness occurs it can be difficult to correct. Mild improvement can be seen with an injection of a different medication but for most patients they need to wait 3-4 months for the Botox effect to go away and the eyelid will come up. Thankfully I have not had this occur to my patients but it is always a risk that we work to try to avoid.

More info is on my Botox page here:

http://www.timsayedmd.com/facial-plastic-surgery-newport-beach/botox-dysport/

-- Dr. Sayed


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