Botox in forehead causes wrinkles above eyebrows. Can I do anything immediately? (Photo)

Doctor Answers 16

Wrinkles after Botox

Thank you for your question Myzoba. I am sorry to hear about your situation. Botox is a purified protein used to address wrinkles associated with facial expression. It is important to clarify what forehead means because there are two groups of muscles in this area. The glabella is between the brows and is responsible for pulling the brows down when one frowns. The frontalis is a broad muscle that lies across the upper forehead and is responsible for raising the brows. Some people have the glabella treated and say the forehead was treated. If this is the case, then the glabella muscles are relaxed and the frontalis acts unopposed and wrinkles may be seen above the brows. This is more common on the outer forehead because treatment of the glabella often relaxes the middle portion on the frontalis. Treatment to the lateral frontalis can correct such concerns. I normally treat both areas to avoid such issues. Please consult with a doctor for specific recommendations. Good luck!

Encino Physician
5.0 out of 5 stars 4 reviews

Forehead creases with Botox

I agree that it appears the lateral forehead was not properly treated.  It may be that they either hoped it would "take" or that an insufficient amount was used.  If the problem persists more than 2 weeks after injection I would have them take another look and possibly treat the unaffected area with more Botox.

Reza Tirgari, MD
San Diego Physician
5.0 out of 5 stars 4 reviews

Wrinkles after Botox

From your picture it appears as though you had your central brow treated but not the outer aspects of your brow. The botox is not creating wrinkles but rather is not present there, so your frontal muscle is still making the wrinkles because it wasn't treated. This is an easy fix, a conservative treatment with more Botox where the wrinkles are will soften them and give your brow a more balanced look.

Matthew Brace, MD
Ontario Facial Plastic Surgeon
5.0 out of 5 stars 5 reviews

Botox In Forehead Causes Wrinkles Above Eyebrows. Can I Do Anything Immediately?

Thank you for your question and for sharing your photograph.  Sorry that you are having some concerns about your postprocedure appearance.  Botox to your lateral forehead area needs to be carefully administered to avoid brow droop.  A small amount of additional Botox may help to soften your lateral forehead creases.  I would suggest that you see your injector for an in-person reevaluation to fully discuss your concerns and your goals and expectations in order to determine the best treatment plan.  Hope this helps and best wishes!

Christian N. Ford, MD
Cohasset Physician
5.0 out of 5 stars 31 reviews

Botox in forehead causes wrinkles above eyebrows

Thank you for posting your photograph along with your interesting question. The area of the forehead above your eyebrow can be a challenging area to inject Botox, because this area has the greatest chance to develop eyebrow droop or ptosis, which is uncommon with experienced injectors. In patients who have low eyebrows, Botox can be injected in the middle and the upper forehead, producing eyebrow lift. Unfortunately, the forehead muscles doing the lifting can bunch up and produce these visible wrinkles. That being said, a micro amount of Botox can be used to "touch up" that  forehead area to relax those wrinkles without producing eyebrow drooping. Please consult a Board Certified Plastic Surgeon who is experienced with this Botox technique. It is the skill of the injector that determines the best Botox results. Best wishes, Dr. Richard Swift

Richard Wellington Swift, MD
New York Plastic Surgeon
5.0 out of 5 stars 24 reviews

Botox-Related Wrinkles Over Eyebrows Easily Treated With A Few More Droplets Of Botox

No need to worry. I have been injecting Botox for aesthetic reasons since 1991, and the kinds of wrinkles over your eyebrows that you show in the photo occasionally occur when an injector, usually an inexperienced, novice injector, does not place the Botox in a balanced way and inadvertently gives the competitive edge to the opposing muscles. Fortunately, this is easy to treat. A microdroplet or two of additional Botox on each side placed in the appropriate locations will help to soften the wrinkles that disturb you. Having said that, you should also know that, in order to prevent a sagging brow, Botox is not injected in the 3/4 inch to one inch region immediately above the brows, meaning that any etched wrinkles in that region are best addressed with fillers. Going forward, make sure you consult with a board certified aesthetic physician and ask to see his/her before and after photos. Best of luck, and not to worry.

Nelson Lee Novick, MD
New York Dermatologic Surgeon
4.9 out of 5 stars 32 reviews

Botox and Eyebrows

You are not a candidate for botox here as it will drop your eyebrow.  If you get excessive wrinkles even with botox you need lasers and skin tightening procedures to help.  Best, Dr. Emer.

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.8 out of 5 stars 196 reviews

Botox and touching up forehead wrinkling

Botox is a medication injected into target muscles of the face to produce softer/fewer wrinkles.

An expert injector understands the balance of pull between the muscles of the face. Wrinkles on the brow after a Botox treatment is a result of an imbalance. This can be addressed with additional Botox; however too much may risk a heavy forehead and drooping brow. Multiple, small-dose injections can reduce the risk of droop. It's more important to evaluate the face and identify patients at risk for forehead wrinkling and brow droop. Before injecting, I like to examine my patients' faces at rest and in motion. I also take photographs. Each patient's treatment is tailored for a safe and happy result. Safety comes first. 

Victor Chung, MD
San Diego Facial Plastic Surgeon
5.0 out of 5 stars 11 reviews

Botox results

Great question. These wrinkles just above the lateral brow can be difficult to treat. The reason they are so difficult to treat is that too much Botox in this area can cause your brow too droop. That being said, low dose microinjections of Botox, carefully placed by an expert injector may help. 

Shaun Patel, MD
Miami Physician
5.0 out of 5 stars 60 reviews

Commas above brows after Botox

These are somewhat difficult to correct because adding too much Botox in this area can lead to brow drop. However, carefully placed small doses of Botox can improve these. This needs to be done by an experienced injector.

Steven F. Weiner, MD
Panama City Facial Plastic Surgeon
4.7 out of 5 stars 41 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.