Tug of war muscles: Botox Lift

Otto Joseph Placik, MD answers: What is a "Botox lift" or "Botox Brow Lift"?

I thought that Botox could make your face sag more, so how is a Botox Lift even possible? How does a Botox Brow lift work?


Otto Joseph Placik, MD
9 months ago

In physiology, we term the actions of muscles to be agonist and antagonist muscles. This refers to the results of the muscle contraction.

Certain muscles play "tug-of-war" with areas of the face. Examples include:

  1. The corner of the mouth: Muscles lift the corner in a forced "cheeky" smile or turn the corner of the mouth downward with frowning.
  2. The outer part of the eyebrow: The squinting muscles pull the eyebrow downwards while the forehead muscles pull it upward.
  3. The central upper lip : "pursing" muscles pull it downward, whereas muscles just to the outside of the nostril create a "gummy" smile.

If we inject the antagonist muscles, the agonist muscle action will predominate and take over. In the examples above:

  1. Injecting the muscles that pull down the corner of the mouth (the depressor anguili oris) will allow the muscles that lift the corner to take over and minimize downturning or frowning.
  2. Injectting the squinting muscles relaxes the pulling down of the brow and creates a chemical "forehead/brow lift"
  3. Injecting the muscles to the outside of the nostril allows the upper lip to relax and eliminates the gummy look when smiling.

I hope this helps!

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