How does a Botox Brow Lift work?

While Botox can make the brow droop, it can also cause an elevation of the brow.

There are several muscle groups which work to move the brow. There are a set which moves the brows up and a set which moves the brows down. By selectively injecting the muscles which move the brow down, there is unopposed action of the muscles which move the brow up. Hence - a brow lift.

While this works well, the effects are temporary and minimal. For patients with severe brow ptosis and fat pseudoherniation, a surgical brow lift may still be the best result.

Caution also must be used when injecting the muscles that pull the brow down as these can be close to the orbital rim. Injection too near the orbital rim can result in migration of the Botox into the upper eyelid and cause a temporary eyelid droop.

All parts of our bodies are supplied by muscle groups that work in opposition to each other for complete and proper function. In the arm, for example, we have the biceps muscles to flex the elbow and triceps muscles to extend the elbow. In the forehead as well, there are muscles that elevate the brow and others that pull it down or depress it.

The ones that pull the brow up cause the sideways lines of the upper forehead and those that pull the brow down cause the vertical frown lines above the nose. By temporarily paralyzing the depressor function with injections of Botox above the nose and in the lateral eyebrow, the muscles the lift the brow can cause a subtle brow lift because their function is unopposed for about 4 months. For may patients this may be all they require and can avoid the need for a surgical browlift.

Dr. Chung gives an excellent lesson on how the "Botox brow lift" may be achieved.

I find Dr. Caschette's input is helpful as well, but I would like to address his recommendation that Botox only be administered by a physician. Let us not forgot that there is enough room in this industry to recognize that other practitioners can be just as skilled in the area of aesthetics - including Botox treatments.

With that said... using Botox to elevate the brow is an excellent option when one is not a candidate for surgery. Understanding the facial muscle groups, which muscles are opposing (as Dr. Chung so wisely stated), appropriate dosing, etc. all go hand in hand to deliver consistent, predictable outcomes.

In our practice, we like to suggest that the Glabella area (between the eyebrows) also be treated as these muscles act as a brow depressor in conjunction with the orbicularis (eye muscles). Utilizing the lateral brow lift of approximately 5 units to the outside edge of the eyebrows usually provides a natural, pretty, lifting of the brows. Most of our female patients find much value in this simple technique.

{Editor's note: the remainder of this post has been moved.  Please see Lori Haney, R.N.'s answer to "Botox injections - who is qualified to administer them?"}

When used by doctors with expertise in Botox injections, patients can, in fact, get a “Botox Brow Lift.” Some Doctors will refer to this as a “Non-Surgical Brow Lift” in their advertising.

When injected, Botox stops muscles from contracting for 3-4 months. Most commonly, doctors use Botox Cosmetic to stop muscles from moving that cause facial wrinkles. One area that is commonly injected is the “Crow’s Feet” region.

To relax the “Crow’s Feet,” the outside (lateral) part of the circular muscle located around the eye (the “orbicularis oculi”) is injected. When the orbicualris oculi muscle contracts, it pulls the outer corners of the brows down and toward the nose. If we inject at the upper outer sides of this muscle, close to the outer side of the eyebrows, we can see a ”raise” of several millimeters of the sides of the eyebrows. Usually, 2 to 7 units of Botox in this spot on each side can achieve this effect.

A “Brow Raise” can also occur when injecting the forehead with Botox. Most experienced physicians do not inject Botox on the sides of the forehead, as this can cause a “dropped” appearance of the sides of the eyebrows. As a result, the middle of the forehead muscle (the “frontalis”) is injected and is less active. This means fewer wrinkles in the middle of the forehead and less ability to raise the brows. If the sides of the forehead are not injected, the frontalis muscle there can raise the sides of the brows more- thus, another way to cause a “Botox Brow Lift.”

A warning here: patients should be evaluated before injecting the forehead muscle to make sure this muscle isn’t being used to raise up a sagging brow. If the brow is naturally “dropping,” and the forehead muscle is pulling it up while we’re awake, Botox injections in the forehead will stop the forehead muscle from contracting. The result? The brow can drop- making the patient look “tired.” Worse yet, if there’s also “droopy upper lids,” the lack of forehead tone could cause impingement on the patient’s upper field of vision. This is just another reason why patients should always be treated by an experienced physician.

Remember- It’s Your Face! For best results, seek out a medical doctor with experience in Botox injections for best results.

{Editor's note: the remainder of this post has been moved.  Please see Joel Caschette, M.D.'s answer to "Botox injections - who is qualified to administer them?"}