Spock-Eye Fix they did a feathering kind of manipulation to the skin around my brow after injection. What is this method called?

Question

I normally get spock-eye results after Botox treatment. When I get a 'touch-up' to correct the spock eye, my eyelid sags so much I could hardly see. I tried another doctor and instead of more botox, they did a feathering kind of manipulation to the skin around my brow after injection. What is this method called?

Martin Jugenburg, MD · Answer

Thank you for your question. There is not a specific name for the technique to are describing. Injectors can have different methods for injecting Botox, typically created through experience. Best,

James R. Gordon, MD, FACS, FAAO · Answer

Thank you for sharing your issues. When injected properly, Botox should not give the Spock appearance. I am not aware of a specific term for injecting Botox in the manner you describe. Always have experienced injectors perform your treatment.Good luck,

Jason E. Leedy, MD · Answer

Spock-eye, or the McDonald's arches look, after botox is the result of too much botox in the central brow/lower forehead and not enough in the lateral/superior forehead.  The superior forehead muscle contracts normally but the central forehead is too weak  so the central brow droops and the lateral brow raises up.  This creates the less-than-ideal, clown-like brow shape.  So in order to avoid that it is important for the doctor to not be so heavy handed with botox medially and to use an appropriate amount in the appropriate position in the superior/lateral forehead.  Every patient is a little different and the correct amount of botox depends on the strength of the muscles, the depth of the lines, the pre-treatment brow position, etc.  The good thing is that the spock-eye can often be corrected with just a little more botox given in the forehead where the peaking occurs.  Sometimes as small as 1/2 a unit makes all the difference.  Make sure you discuss your desired brow shape with your doctor before treatment.  Best of luck!

Corey Frucht, MD, PhD · Answer

Hello, and thanks for your question. This is one of the trickier aspects of injecting Botox. Not enough Botox to the side of your forehead and you run the risk of "spocking." With too much, you run the risk of dropping your brow. To maximize the likelihood of a favorable outcome, I recommend that you only get treated by a well-trained and experienced dermatologist or plastic surgeon. Hope this opinion is helpful to you. Best of luck, Dr. Frucht.

Jesse E. Smith, MD, FACS · Answer

A small amount of Botox can be added in and around the muscle that is causing this contraction and raising of the brow.  Usually this is in the outside aspect of the forehead.

Michele S. Green, MD · Answer

This can happen at times and is remediated by adding more Botox to the forehead to correct this area. In the future you will need a small amount of Botox in the forehead to combat this. Please consult an expert. Best, Dr. Green

Andrei Metelitsa, MD, FRCPC, FAAD · Answer

Spock eye is often a technique related phenomenon although there are certain patients who are more prone to this side effect. You should definitely communicate such history to any new physician injector.if they are only treating you for glabellar lines (11's) they should consider a very tiny dose of Botox in your side forehead region to prevent your brows from "shocking in the future".  If your doctor injects too low on the forehead or too high of a Botox dose in an attemp to prevent Spock eye, there is a chance you will get eyelid drooping (brow ptosis) that you are describing.

Mark Lupin, MD · Answer

There are two types of spocking.  The first is due to an imbalance related to treatments like Botox.  The second is a normal event due to aging and genetics where the brows slowly become heavier as we age.  The reason for the spocking in both cases is over-active use of the forehead muscle called the frontalis muscle.  In the case of age-related spocking, this is normal compensation for the heavy brows - i.e. the forehead muscle is trying to pull up the brows - which leads to the spocked look.  If you are getting spocking after Botox treatment, then this should be correctable with a very small dose of Botox in the outside portion of the forehead.  Massaging and/or other manipulation of the skin after Botox injections is not a recognized method of treating spocking nor of any other aspect to results following Botox treatments.  In fact, the recommendation is to avoid rubbing or otherwise manipulating the skin after treatments.   There are methods to placing Botox to avoid spocking and this placement and dosing requires a very experienced injector.  You should not need to repeatedly follow up for "touch-up" treatments.General advice here is to follow up with the injector and have a frank discussion as to whether you have pre-existent brow heaviness which is being exacerbated by less than ideal placement of Botox.  If that is the case, Botox can be placed to avoid spocking entirely; and more importantly, there may be other treatments besides Botox to consider to help lift the brows.  Two examples of non-surgical lifting treatments are a focused ultrasound device called Ulthera and for some patients, dermal fillers can be helpful to lift the brows.  It is always important that results look natural.

Elena Vega, DO · Answer

There is no particular name for the way the doctor injected.  It is just their personal style to help prevent the "spock" look following Botox injections.

Jo Herzog, MD · Answer

Spock eye happens when the center of the brow gets lifted and the forehead above it is not relaxed to drop it back down. When my patients know that they are going to get this I inject a tiny amount of toxin above center of brow to release this. This still has to be high enough not to cause a negative effect. I don't think that feathering in itself matters other then it might be your doctoors way of using small amount to not over do

Spock-Eye Fix they did a feathering kind of manipulation to the skin around my brow after injection. What is this method called?

Answers (10)

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