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Can Too Much Botox Cause Eyebrows to Drop?

asked 4 years ago by anon
Latest answer by Ghada Afifi, MD
Question viewed 69,182 times
Tags: droopy

I have been getting Botox for about 4 years and everything has been great. This time when I got it, it made my one eyelid look like it was a double eyelid (kind of baggy).  However, I thought I noticed that my eyelid needed a lift before I went this time, but now it's worse. And both my eyes are baggy in the corners. Both my eyes feel heavy. I'm 40 years old but never had any of these problems before. Will this go away when the Botox is out? Did she give me too much??

31 answers to Can Too Much Botox Cause Eyebrows to Drop?

+1

Botox and eyebrow droop

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... more
Harold J. Kaplan, MD

Los Angeles Facial Plastic Surgeon

www.celibre.com

+4

Droopy eyebrow after Botox injection

The problem that you present is most likely due to excessive Botox injection, or placement of too much Botox in the lateral forehead region. Fortunately, as the Botox wears off, your eyelid should improve. A more uncommon problem is when Botox is injected too low and it seeps into a muscle that elevates the eyelid. This can lead to true eyelid droop. If the same doctor has treated you successfully for 4 years, I suggest you discuss your concerns with her, so the next time you won't... more
Maurice M. Khosh, MD

New York Facial Plastic Surgeon
+4

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... more
Sanjay Grover MD

Orange County Plastic Surgeon
+4

Droopy eyelid

There are 2 ways to have this problem from Botox injections. If the product is placed too low on the forehead, the muscle that raises the forehead (frontalis) will be inactivated and not able to lift the brow. A droopy brow can look like a droopy lid , but usually will correct if you pull the lateral brow upward with your finger. If it corrects by you doing this, a little Botox placed by an experienced injector into the lateral tail of the brow, into the eye muscle (orbicularis) may help... more
Shawn Allen, MD

Boulder Dermatologist
+3

Botox can cause the eyebrows to move like a "see-saw"

Botox can cause the eyebrows to drop in position especially if too much is injected into the elevators of the forehead. The balance in eyebrow position depends on precise administration of botox into the depressors and elevators of the forehead. If too much botox is placed into the muscles that elevate the forehead, then the net result is a downward or heavy position to the eyebrows often creating the look of a heavy upper eyelid. The opposite can be done if too much botox is placed into the... more
Scott Trimas, MD

Jacksonville Facial Plastic Surgeon
+2

Botox problems

When the eyes feel a bit low, then more than likely the botox was injected a bit low and the frontalis muscle can not elevate the brow.
Steven Wallach, MD

Manhattan Plastic Surgeon
+2

Botox causing Eyebrow Droop

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... more
Daniel Reichner, MD

Newport Beach Plastic Surgeon
+1

Too Much Botox can Cause Eyebrows to Droop

The frontalis muscle is the muscle in the forehead that holds or pulls the eyebrows up. To much botox in the forehead can definitely over treat this muscle and the brow can droop down, which may result in the appearance of excess skin in the upper eyelid area. This is especially true in some patients that tend to have low brows and who rely on their frontalis muscle to hold their brows upward. The amount of botox can be too much or it may have been placed too low... more
Ghada Afifi, MD

Orange County Plastic Surgeon
+1

Heavy eyebrows and Botox

There is a large muscle above each eyebrow that functions to lift the eyebrow. Over time, this can create furrows across the forehead. These furrows can be improved by injecting Botox into the muscle over each eyebrow. The goal is to weaken this muscle but not to completely paralyze it. If too much Botox is used or if it is placed too low on the forehead, it can cause the eyebrows to feel heavy or look like they are sagging. This is one reason doctors tell their... more
Edwin C. Pound, III, MD

Atlanta Plastic Surgeon
+1

Imbalanced delivery of Botox can cause brows and/or eyelids to droop.

As a targeted muscle relaxing medicine, Botox is a wonderful way to treat wrinkles, and to rebalance the muscles around the eye area to shape the brow. In the process, the brow can be lifted, or dropped, depending on the balance struck. A lowered brow can cause the hooding you describe. Return to your surgeon to see if adjustments can be made. If not, rest assured the condition will resolve spontaneously over a few weeks to months. Best, Mike Nayak more
Laxmeesh Mike Nayak, MD

Saint Louis Facial Plastic Surgeon
+1

Effect of Too Much Botox in the Eyebrows

The drooping of your eyebrows can be caused by excessive Botox as well as injection in the wrong area. There are muscles in your face that keep your brows elevated. If Botox was injected (too low) in the wrong location in the frontalis muscles, this will cause them to relax, resulting in the eyelid droop that you are describing. As you know, Botox works by keeping muscles relaxed. It prevents nerve cells from releasing a chemical signal called acetylcholine. Botox molecules... more
Sanusi Umar, MD

Redondo Beach Dermatologic Surgeon
+1

Botox and baggy eyelids

Yes, botox can cause heavy upper lids. Maybe your doctor injected more than usual, or closer to your eyebrows than usual, you should call this reaction to their attention. If everything was done the same way as in the past, then it may just be the aging process and as you said, you have a heavy upper lid anyway and its getting worse with time. That's when its time to see a good plastic surgeon and see if you are a candidate for eyelid surgery. To further answer... more
Rebecca Baxt, MD

New York Dermatologist
+1

Use Botox Sparingly with a Tall Forehead or Heavy Eyelids

I have been using Botox since the 1990's when everyone wanted a "frozen forehead'-without a line or crease. But the trend quickly shifted to a softer, non- paralyzed look in the forehead. If you have a tall forehead or already have heaviness in the upper eyleids, I recommend treating the frown lines and crow's feet before the forehead, to minimize the brow droop.
Edward Szachowicz, MD, PhD

Minneapolis Facial Plastic Surgeon
+1

Botox and Eyebrow Position

Botox is often used to give a slight lift to the eyebrows by treating the brow depressor muscles. Often in the same treatment, the frontalis muscle (which elevates the brows and also causes horizontal forehead lines) is treated. The balance of these treatments is key in getting pleasing results. If the frontalis is treated more significantly than the depressors, then the brow will tend to descend and crowd the eyelids. Mark Lucarelli, MD FACS Madison, WI more
Mark J. Lucarelli, MD

Madison Oculoplastic Surgeon

www.UWHealth.org

+1

Botox and droppy eyelids

To much Botox or Botox placed in the wrong area can cause heaviness to the eyelids. It is important to make sure the injector has had advanced training and has a lot of experence when getting Botox,fillers or any other cosmetic service. First time Botox users in our facility are charged $10.00 per unit. Reg. $13.00 per unit.
Vincent N. Zubowicz, MD

Atlanta Plastic Surgeon
+1

Too much Botox in the forehead

I suspect that too much Botox was injected into the forehead.  The frontalis muscle holds up the eyebrows and occupies the entire forehead.  Although it is good to smooth out the horizontal forehead lines with some Botox, sometimes too much is placed in the forehead and the brows drop and the eyes appear heavy.  There is a another injection that can sometimes be helpful to raise the brow back up so check with your doctor.  Fortunately, the effect is temporary and can be... more
Kimberly Butterwick, MD

San Diego Dermatologic Surgeon
+1

Botox, Wrinkle Treatment, Beverly Hills Botox, Los Angeles Botox, Nasal Surgery, Beverly Hills Rhinoplasty

Yes, Botox or Dysport can cause the eyebrows to droop which may make it look like there's excess skin "hooding" of the upper eyelids.  Botox and Dysport act to relax muscles that cause unwanted lines and wrinkles.  If Botox or Dysport are injected, in an area of the forehead, that's too close to the eyebrows it may weaken the muscles that keep the eyebrows elevated resulting in what you're describing.  There are a couple of things that you can do if this... more
Francis R. Palmer, III, MD

Beverly Hills Facial Plastic Surgeon
+1

Botox Droop

Injecting Botox into the forehead can cause a droop of the brow.  The muscle injected to treat horizontal forehead lines also serves to elevate the brow.  If you relax the muscle that pulls the brow up it can lead to a droop.  Sometimes this can be fixed by injecting the muscles that pull the brow down (brow depressors).  I think that it is important not to over inject the forehead.  I made that mistake when I first started injecting Botox in 1997 when I thought... more
Jerome Potozkin, MD

Walnut Creek Dermatologic Surgeon
+1

Can Too Much Botox Cause Eyebrows to Drop?

Botox paralyzes muscles.  Therefore, if your forehead muscles are paralyzed and you have loose eyebrows, your eyebrows will droop. From your question, it may be you also have some ptosis which is actual eyelid drooping.  That is a complication of Botox.  You need to make any physician aware of that fact if you have Botox injected again. In general, once the Botox wears off, the eyelids and eyebrows return to their original positions.
Sam Goldberger, MD

Beverly Hills Oculoplastic Surgeon
+1

Yes, too much Botox above the brows can cause them to drop.

Botox works by weakening muscles. There is a flat band of muscles that goes from your eyebrows up to your scalp. If that muscle is overtreated, you will not be able to lift your eyebrows, and if it is severely overtreated, it will not maintain its natural "tension" that keeps your brows in place, thus allowing them to droop or even just feel heavy. Luckily, this is temporary, and will wear off as the Botox does, but be careful not to allow yourself to be overtreated.... more
Jessica J. Krant, MD, MPH

Manhattan Dermatologic Surgeon

www.ArtofDermatology.com

+1

Botox and eyelids

If the eyelid is droopy itself, it could be the botox infiltrated into the eyelid lifting muscle. Alternatively, if the forehead was treated extensively, the botox could cause the frontalis muscle to drop the brows. Either way..it wears off when the botox wears off but should go back to normal in 6-8 weeks. 
Chris Thiagarajah, MD

Washington DC Oculoplastic Surgeon
+1

Caution with Botox treatment

The condition you describe can be cause by at least two different ways.  As we age the forehead tends to settle a bit, and we keep the brows up by by having our forehead muscle slightly contracted.  If too much Botox is injected than the muscles is no longer able to keep the brows up and we get the droop. The other way, is if Botox migrates to the levator muscle, and the patient can get a true eyelid droop.  Good news is that as Botox wear out so will the droop. Even... more
Boris M. Ackerman, MD

Newport Beach Plastic Surgeon
+1

Botox and heavy lids

eventually, as we age, we get to a point that our foreheads have drooped so much that we can't have the same number of units of botox as we have had repeatedly in the past.  We have to start injecting only the upper not mid or lower forehead, and make sure that we do inject the glabella, between the eyebrows, at the same visit that the upper forehead is done, to avoid drooping of the forehead.
Ronald Shelton, MD

Manhattan Dermatologist
+1

Eyebrow droop vs Forehead Lines

I am not clear on what areas were treated, however; it is possible to cause the brow to droop if Botox is injected too low into the frontalis muscle, or if too much Botox is injected into the frontalis muscle. The outcome is temporary and your brow will return to its normal position once the Botox has worn off. To achieve more of a lift and reduce the risk of the brow drooping, I prefer to treat the glabella region along with the frontalis muscle. This approach gives a more balanced result.... more
Joseph Serota, MD

Denver Plastic Surgeon
+1

Forehead droop

Botox injected in the central forehead above the pupils can result in a lack of elevation function of the brow and the resulting heavy eyelids.   The result can last several months.  To avoid this occurrance , botox is best kept in the central  forehead and lateral brow and crowsfeet. 
Lee Kleiman, MD

Annapolis Facial Plastic Surgeon
+1

Technique is important to avoid eyebrow droop with Botox

It isn't so much a matter of quantity, but precision with where the Botox is placed to avoid eyebrow droop. The horizintal lines that appear in the forehead are the reult of constant contraction of the muscles that elevate the brows, and since Botox works by relaxing muscles it follows that some droop of the eyebrows can occur. Part of the technique is to consider counteracting this by using some in the muscles that pull the eyebrows down (these are the ones that cause "crow's... more
Richard Baxter, MD

Seattle Plastic Surgeon
+1

Poorly placed Botox CAN cause eyebrows to become heavy and drop

The eye brows are kept up by the pull of the Frontalis muscle. With time, as there is more forehead skin, increased work is required by the frontalis to keep the brows up. The work of the frontalis to wrap up a wider area of forehead skin is manifested by the appearance and deepening of transverse forehead lines. If the injector is inexperienced or ignorant of frontalis function, he/she will not understand that the muscle portion just above the brows should NOT be weakened by Botox. In your... more
Peter A. Aldea, MD

Memphis Plastic Surgeon
+1

Heavy eyelids after Botox

It is not unusual to report the sensation of heavy eyelids after Botox treatment. Also, ptosis , which is drooping of the eyelids, can occur after Botox injection. The incidence has been reported in various source anywhere from 3-4 % of injections. I my experience, we see it much much lower but do see it on occasion. It does not necessarily imply that you received too much Botox as it may be related to placement or diffusion of the Botox. The good news is that it is not a serious side effect... more
Steven Hacker, MD

West Palm Beach Dermatologic Surgeon

www.palmbeachdermasurgery.com

+1

Botox may prematurely relax the eyebrows

Botox Cosmetic is produced by Allergan and is a commercially available form of Botulinum serotype A. Botox inhibits the release of arch and relaxes muscle tone in the areas of injection. If injected into the area of the forehead directly above the eyebrows, it may cause premature relaxation of the eyebrows. This can be prevented by judicious use of the Botox by an experienced plastic surgeon or dermatologist.
Raffy Karamanoukian, MD

Los Angeles Plastic Surgeon
+1

Take your pick: Brows up or Brows down with Botox

The eyebrow position is a delicate balance between the: Muscles that pull it up (the forehead), which elevate Muscles that pull it down (the eyelid), which depress Botox can be injected into the: Elevators (lifters), which will cause the brow to drop Depressors, which will cause the brow to rise (chemical brow lift)
Otto Joseph Placik, MD

Chicago Plastic Surgeon

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