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Will my Droopy Eyebrow Caused by Botox Go Back to Normal?

I got botox on 1st April this year (2010) for my forehead lines. The Doctor also injected in between and around my eyebrows. Well immediately afterwards I noticed my eyebrows had drooped. They now cover most of my entire eyelid. I cannot apply eye makeup now. I've had botox before and this didn't happen. I think less botox was used then. I mainly want to know will my brows ever go back to normal? It's been nearly 5 months now or has this caused permanent damage?

Doctor Answers 8

Botox effect will wear off

You can be sure, that this effect will not be permanent, if it is Botox related. I have not seen a Botox treatment lasting longer than 8 months. 


Mainz Dermatologic Surgeon

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Will my Droopy Eyebrow Caused by Botox Go Back to Normal?

Short answer -- YES...

A drooping eye-BROW may happen in the following scenarios:

(1) When the brow-elevating muscle in the forehead, the Frontalis, receives too high a dose of Botox.

(2) The Botox is sub-optimally placed too low in the forehead -- it should typically be placed at least 1 cm above the Brow.

(3) Over-injection of the glabella area (between the brows).

(4) It may also happen if you have a low set eyebrow to begin with, in which case any Botox to the Frontalis increases the likelihood of a brow droop.

Ironically, a droopy eye-BROW from Botox can sometimes be improved with MORE Botox -- this time, the Botox is typically injected into the outside (top of the crow's feet) part of the eye (aka the lateral aspect of the orbicularis oculi muscle) to generate a bit of a brow lift in that area -- by injecting more Botox and paralyzing the orbicularis muscle that normally acts to depress the brow in that area, you may get a slight compensatory brow lift...

If the extra Botox does not improve the brow droop, it will likely last as long as the full duration of the Botox -- typically 3-4 months, but may last longer as in your case... Note however, that after 5 months you should have seen some improvement. I would recommend that you return to your physician injector and/or see a neurologist for further evaluation...

In the future, please seek the services of an experienced physician injector.

I think the key with Botox lies in truly understanding the anatomy of the injected area, and more importantly the variability in the anatomy between patients -- for brows, the forehead, and anywhere else you plan on receiving a Botox injection. This includes having a firm understanding of the origin, insertion, and action of each muscle that will be injected, the thickness of each muscle targeted, how deep beneath the skin the actual muscle resides, and the patient variability therein. As an aesthetic-trained plastic surgeon, I am intrinsically biased since I operate in the area for browlifts and facelifts, and have a unique perspective to the muscle anatomy since I commonly dissect under the skin, see the actual muscles themselves, and learn "first-hand" the incredible variability between patients -- live, "on the OR table" -- as opposed to via lectures or a cadaver dissection. For me, this helps guide where to inject and where not to. However, with that said, I know many non-aesthetic trained plastic surgeons and other physicians who know the anatomy well despite not operating in that area, and get good results.

Good luck.

Dr Markarian

Effects of botox are temporary

Hi. The effects of botox are temporary and not permanent. In some cases, the effects of botox treatment may still be evident 5 months following treatment. If the problem is truly related to your botox treatment, then as the effects of botox wear off, the problem should resolve. Always check with your doctor regarding any concerns that you have. Good luck. 

James M. Pearson, MD
Los Angeles Facial Plastic Surgeon
5.0 out of 5 stars 40 reviews

Forehead muscle weakness causing droopy upper eyelids and brows after Botulinum Toxin (Dysport and Botox)

Botulinum Toxin (Dysport and Botox) can cause muscle imbalance and the forehead frontalis muscles may be so weakened that it allows the brow to drop and droopy eyelids to become more apparent. As the frontalis muscle activity returns, this should resolve. 
 

Otto Joseph Placik, MD
Chicago Plastic Surgeon
5.0 out of 5 stars 54 reviews

BOTOX can cause droopy lids

BOTOX can cause droopy lids but it will go back, it may take several months. But after the BOTOX wears off, there shouldn’t be any permanent damage. However, to be safe, you should go to a doctor to be evaluated.

Should

   Brow drop is caused by either too much Botox being placed into the frontalis (forehead) muscle or too low a placement of Botox. Usually, a brow drop will correct itself after a few weeks. The fact that this has taken so long in your case ( at least five months), may be due to the wrong concentration being injected. Personally, I inject 6-10 units into the forehead of a female. I figure I can always add more. However, maybe the dilution was incorrect in your case and what your physician intended to be, say, 15 units turned out to be thirty. Just speculating. 

   Do not worry, though the Botox will eventually wear off. I would consult with the physician who performed the injections. It is possible that areas can be tweaked to help the appearance.  Good luck.

Arnold R. Oppenheim, MD
Virginia Beach Dermatologist
4.5 out of 5 stars 10 reviews

Forehead droop after Botox

If Botox is used too low on the forehead or too many units are used on the correct sites on the forehead, the muscle can weaken so much that it droops and the eyebrows can hide the upper eyelids. If this is what happened, it should definitely reverse soon as there is no permanent Botox muscular effect in this regard of which I am aware. Folllow up with your physician

Ronald Shelton, MD
Manhattan Dermatologist
5.0 out of 5 stars 33 reviews

Bad Botox should NOT be permanent

Just because one is a doctor does not necessarily mean that they are trained in Plastic Surgery. A common pitfall of using Botox on the forehead is misjudging the effort of the Frontalis (forehead) muscles in keeping the eyebrows elevated. In going after transverse forehead wrinkles without taking this into consideration, the muscles are paralyzed allowing the brows to sag.

To fully understand BAD BOTOX please visit my web page which explains everything you need to know to about Botox economics and how to avoid such results in the future.

At 5 months, you should experience SOME return of function of the forehead muscles. If you want your forehead to be smoother and brows lifted you may want to consider a surgical form of brow lift of which there are many variations.

Dr. Aldea

Peter A. Aldea, MD
Memphis Plastic Surgeon
5.0 out of 5 stars 69 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.