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Medial Brow Droop and Overarched Brow from Botox, What Can I do?

I had my first Botox treatment 5 days ago in the frontalis (conservatively) and procerus, for horizontal forehead lines. When I raise my brows, the medial brows droop while the arches go high up, creating an angry look. The area over my middle brow looks puffy when arching. I also have a chronic headache and heaviness between and above between the brows, along with a constant pulling feeling above the arches. Is there a way to correct this? I am going for my follow up next week. What can I do?

Doctor Answers (9)

Overdone Botox

+1

You might need a little Botox on the lateral forehead to depress the over-arching and more in the glabella and procerus region to weaken the depression there.


Las Vegas Plastic Surgeon
4.0 out of 5 stars 6 reviews

Overached eyebrows from botox

+1

This is easily corrected by injecting botox to the outer areas fibers of your forehead muscles. In the future inform you botox injectors of this incident and clarify that you do not want it to happen again. They should know to a void over injecting the outer fibers of the orbicularis occuli in tandem with the paralysis of the middle aspects of the forehead and glabella areas (area between the eye brows).

Sanusi Umar, MD
Redondo Beach Dermatologic Surgeon
5.0 out of 5 stars 22 reviews

Botox

+1

Based on your description it sounds like you may need more Botox units on the outside of your forehead to relax the the brows further.  however, Botox takes about 2 weeks to see the final effect and i would not do any correction until that time because you run the risk of overcorrection. Please have your doctor evaluate. Dr. Halem

Monica Halem, MD
New York Dermatologic Surgeon
4.5 out of 5 stars 6 reviews

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Modification of Botox for the forehead lines

+1

yes, you may need more units of Botox injected to the outer forehead to relax this part of the frontalis muscle so it doesn't overcompensate and pull up too much on the outer eyebrows because it struggles to pull up on the middle forehead but can't. You might need more also, to miniimize the bulge you mention. See your doctor to reevaluate. I would encourage you to wait for two weeks so that the Botox has full effect and the result you have can be modified better.

Ronald Shelton, MD
Manhattan Dermatologist
5.0 out of 5 stars 31 reviews

How to correct arched eyebrows after Botox

+1

The details of your treatment plan are very thorough and help to address the potential problem.  For example, the fact that you received a conservative dose in the forehead but experienced very arched eyebrows is related to the lateral (sides) your forehead and above the eyebrows not receiving the proper attention.  Therefore, this part of the frontalis muscle will continue to pull or actually pull harder which causes the "Spock" look of the eyebrows.    If this does not soften over the next week, your practitioner can easily remedy this with a small touch up dose.

Being that only your procerus muscle was treated, all of the other facial muscles responsible for frowning are still in use which leads to a pulling down and inward of the inner (medial) eyebrows.  This, too, may be corrected by properly dosing additional muscles in this area.  

An experienced injector will know how to prevent these outcomes or, at the very least, remedy these unintended results by offering a touch up.  Understanding how facial muscles work independently and synergistically is vital in developing a natural and satisfying treatment outcome.

Regarding the feelings of heaviness, this too should improve as the proper muscles are treated and begin to relax in response to Botox.  

Be certain to have your practitioner address your concerns so that they may remedy the situation and retain you as a valued patient.

 

 

Harold J. Kaplan, MD
Los Angeles Facial Plastic Surgeon
5.0 out of 5 stars 6 reviews

Medial Brow Droop and Overarched Brow from Botox, What Can I do?

+1

  The effects of the Botox will last about 3-4 months and if you do nothing, everything will return as it was before the Botox was injected.  If the medial brow droop is making your face look angry...a small amount of Botox can be used to lower the lateral section of the eyebrows softening this effect.  Be sure that the MD that does your Botox, Dysport or Xeomin injections understands and follows the proper aesthetics of facial beauty.

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.5 out of 5 stars 12 reviews

You have had an unbalanced botox service.

+1

By analyzing how the face is pulling, yes it is possible to treatment this situation with additional BOTOX to help with the overall facial balance.  Steve Fagien in Boca Raton is a Botox expert who can help you with this.

Kenneth D. Steinsapir, MD
Los Angeles Oculoplastic Surgeon
5.0 out of 5 stars 16 reviews

Results from Botox treatments

+1

Hey Wes!

Well to start it is a little early to see the final results it takes 10 days but I would give it two weeks before doing anything. If the problem persists you need to see a board certified plastic surgeon or some one that is experienced with administering the neuromodulators (Botox, Dysport, Xeomin). The problem sound like not enough was injected at the glabella area so you are not getting enough medial brow elevation the secound problem is not enough spread of the Botox more laterally in the forehead and so over active muscles in that region are elevating your lateral brows!!! If it is only minimal lines right over the lateral brow you can place a few units right at the lines to correct that deformity. So the combination of these problems are creating that look!

Some thing you may want to look into in your area is some one that uses Ultherapy from Ulthera. That may give you the brow lift you are looking to achieve with a longer standing results between over one year to two years!

Good luck !

Tal T. Roudner, MD, FACS
Coral Gables Plastic Surgeon
5.0 out of 5 stars 81 reviews

Correcting "Bad Botox"

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One of the benefits of having your Botox done by a good Plastic surgeon or dermatologist is that they know facial anatomy and can produce the result you want while staying away from results you do not want. Another important benefit is he/ she will soon know how you will react to Botox / Xeomin and will customize the results to you. In your case, the arch can be gently lowered with a few units of Botox above its apex. Just ask your doctor to help you. 

Good Luck. 

Perer A Aldea, MD

Peter A. Aldea, MD
Memphis Plastic Surgeon
5.0 out of 5 stars 62 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.