Too much Botox or a little in the wrong place can cause droopy eyebrows

Too much Botox or even a little in the wrong place can cause your eyebrows to droop.  

As you know, there are muscles that work to lift the brow (the frontalis muscle in your forehead) and muscles that can pull down the brow (the orbicularis muscle around your eyes).  They work in balance. 

One can achieve a nice 'chemical browlift' by injecting appropriate amounts in the right spots. 

However, if you have a tendancy towards too droopy of a brow or too much excess skin, Botox will not help and you would benefit from a blepharoplasty or browlift.

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The botox injections have to be balanced - some above and some below the eyebrow.  This is a technique that a good plastic surgeon uses all the time.  The frontalis and obicularis oculi muscles are "antagonistic muscle pairs"  for eyebrow position - when one contracts the other relaxes - changing the eyebrow position. 

The skill part of injecting botox is understanding the anatomy of the antagonistic muscle pairs in the face and injecting the right amount of botox in the right places to control the position of the eyebrows. It sounds like too much botox was injected above your eyebrows causing them to droop. The best correction for this problem is an botox injection into the antagonistic obicularis muscle. 

I also recommend that you seek a Board Certified Plastic Surgeon for all plastic surgery on soft tissues around the eye.  This includes Botox, Juvederm, Restylane, Eyelid surgery, Browlift and other surgical procedures.  Board Certified Plastic Surgeons have 2 to 3 years of comprehensive formal plastic surgery training on the aesthetics, anatomy and function of the soft tissue, muscles and bone around the eye.

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Botox can very easily cause the condition you described (ptosis or a sagging eyebrow) when injected incorrectly. In fact, it does not take an awful lot of Botox to cause this problem. This condition occurs when too much Botox is placed in the muscles above the brow that pull upward. Relaxation of this muscle with Botox causes the brow to sag.

We wondered if the practitioner that caused the problem was also the same one that was providing the injections for the previous 4 years. Switching practitioners always involves a bit of risk, especially when switching to one less experienced.  When a practitioner knows the location and dosing well for your particular facial anatomy, sometimes it makes sense to stick with him/her as results will generally be consistent.

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