Arched Eyebrow with Ptosis/Botox?

One eyebrow is arched higher than the other eyebrow; I also have eyelid ptosis on that side. As I get older, the vertical line above this eyebrow is getting deeper. Also, if I wake up in the middle of the night this eyebrow is arched up and I can't get it down which adds to the forehead line. I want the eyebrow down, but don't want the ptosis to get worse. Where would botox be injected and would I have the other side done, too? How many units of botox would I request? Thanks,

Doctor Answers 10

Using Botox in people with non symmetric brows

Best to speak with a highly trained and experienced injector physician such as a dermatologist to be able to help what sound like a more complex case. The amount injected is determined by watching you use and move your muscles and so can't be done via static computer. There are general suggestions that can be made, but age and other factors are important in determining this. 1-3 units above your arched brow can nicely bring it down to match the other side. ~ Dr. Benjamin Barankin, Toronto Dermatology Centre.

Toronto Dermatologic Surgeon
4.8 out of 5 stars 50 reviews

Treating ptosis

Ptosis is usually accompanied by an arched eyebrow.  Your forehead muscle is trying to compensate for the fact that your eyelid is not lifting.  You might consider a surgical option to correct this problem. 

I have also combined treatments with good success:

1) to lower the arched brow, I inject a small amount of neurotoxin into the forehead muscle just above the peak of the arch

2) to lift the lower brow, I inject a small amount of botox into the lateral brow.  Also, we can combine with ultherapy on the part of the forehead above the lower brow to lift it. 

Melissa Chiang, MD, FAAD
Houston Dermatologic Surgeon
5.0 out of 5 stars 12 reviews

Arched eyebrow after Botox

This can be made better by artfully and skilfully inecting Botox right above the arched area without compromising your eyelid ptosis. Hratch Karamanoukian MD FACS Buffalo Botox

Hratch Karamanoukian, MD, FACS
Buffalo Phlebologist
4.8 out of 5 stars 41 reviews

Botox and brow correction

Without first seeing you in person or viewing pictures, it is very difficult to answer your question. If you're provider is well-trained, informed, and good, you should have no problem returning for assessment. You may just need a few units above your peaked brow to bring it down, without interfering or causing/worsening a "ptosis" situation.

Sam Naficy, MD, FACS
Seattle Facial Plastic Surgeon
4.7 out of 5 stars 221 reviews

Eyelid ptosis

Good news for you in that both conditions can be solved with a relatively simple procedure which is covered by most insurance carriers.  Once you correct the eyelid ptosis, your brow will stop trying to compensate for it and the forehead rhytids may well return to normal. 

David Marcus, MD
Santa Rosa Plastic Surgeon
4.9 out of 5 stars 33 reviews

Surgery not Botox

It sounds like you have eyelid ptosis, and your forehead muscle is trying to help out. Botox will eliminate your forhead wrinkles, but will likely inhibit your forehead muscle's compentation for the eyelid ptosis and make the sagging worse. If you want the eyebrow down and the ptosis repaired you need surgery.

A careful examination will reveal which procedure will work best. It would be very unusual for Botox to help in the situtation you are describing, but again, an examination would be needed to confirm this. See a Board Certified Plastic Sugeon who has experience with treating ptosis. You may need only ptosis repair, ptosis repair with blepharoplasty and evaluation of you brow to see if brow surgery is indicated.

Joseph Mele, MD
Walnut Creek Plastic Surgeon
4.5 out of 5 stars 17 reviews

Ptosis with arched brow

The brain often tries to compensate for a drooping eyelid by activating the forehead muscles and pulling the brow upward. This is done subconsciously to help your eye open better. Putting botox into your forehead will make you lose this compensatory mechanism and probably make your eye feel even more droopy. See an oculoplastic surgeon for an evaluation for ptosis repair surgery. Often times, the arched brow will return to a normal position once the ptosis is fixed. 

Mitesh Kapadia, MD, PhD
Boston Oculoplastic Surgeon
5.0 out of 5 stars 164 reviews

Arched Eyebrow with Ptosis/Botox

It is hard to know what is going on without a picture or an exam. It is possible that your excessively arched brow is your body compensating for the lid ptosis on that side by contracting the forehead musculature. To that end, I would advise you to get evaluated for your ptosis. If it is of the variety that is due to aging or loosening of the muscular attachment to your lid (most common), it would be better to get that repaired first. You should seek a surgeon who is experienced in ptosis repair.

Michael Kim, MD


Michael M. Kim, MD
Portland Facial Plastic Surgeon
4.9 out of 5 stars 39 reviews

Botox for an arched eyebrow

You should consult a dermatologist or plastic surgeon who is experienced in injecting Botox.  You need to be assessed to see if Botox would be an appropriate treatment for you.  Your specialist would determine the placement and amount of Botox necessary.

Martie Gidon, MD, FRCPC
Toronto Dermatologist
5.0 out of 5 stars 22 reviews

Eyelid ptosis

If you have true eyelid ptosis, Botox is not a good idea because your forehead is probably helping to keep the lid up.  Best to be seen for possible ptosis repair first.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 28 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.