Is botox the answer for the sagging on my face?

Thank you for your question. I understand that at 15 years old, you were hit on the right brow with a cricket bal, that it was very swollen and required stitches. Now that you’re 27, you’re looking into some options to improve your appearance. The cosmetic surgeon you met with suggested Botox, and you’d like to know if this is of value to you.I can help you with this concern as a Board-certified cosmetic surgeon and Fellowship-trained oculofacial plastic and reconstructive surgeon. I’ve been practicing Manhattan and Long Island for over 20 years, and working with eyes is a big part of my practice.Looking at the photos you submitted, I will point out a few things, and it’s your decision if you feel that these are significant or not. On your right brow, there appears to be a scarred area that doesn’t have any hair, and I assume this was the area that was sutured. I also notice that the eyelid crease on the right eye is not as defined as the left eye, and that the right brow is slightly lower than the left side.I think when your doctor mentioned the use of Botox, they thought about achieving improved symmetry by applying Botox on the frontalis muscle on left brow area. The frontalis muscle is what is responsible for lifting the brows, so placing Botox into the higher left brow will result in the relaxation of the muscle, and the subsequent dropping of the left brow. Keep in mind that this would make your eyes appear less open, and as such, we would need to consider just how beneficial it is to paralyze the opposite muscle just to achieve symmetry.As an insight of what we do at our practice in situations wherein patients have asymmetric eyebrows, a brow lift is not a practical option. We would perform an upper eyelid blepharoplasty and remove a bit of skin to create balance and symmetry and also to make the eyes appear more open. This could be more practical since I don’t think people look at your eyebrows, but rather your eyes.Another possible solution is to try to create a little bit of a brow lift effect using Botox. This is done by injecting the brow muscles, or brow depressors, so that they become relaxed and lifted. However, in the absence of a physical exam, it is difficult to tell if this would be effective, given that this was an injury.Overall, from a practical perspective, I don’t think that there is anything aesthetically significant that needs any aggressive action. I would, in fact, even defer any procedures until a few years later. I do think that it’s important that you meet with experienced and qualified cosmetic surgeons to get their opinions on your case. There’s always a textbook way of approaching cases like these, but something as invaluable as a doctor’s experience can help solve problems in a way tnot written about in textbooks or found online.I hope that was helpful and I wish you the best of luck!This personalized video answer to your question is posted on RealSelf and on YouTube. To provide you with a personal and expert response, we use the image(s) you submitted on RealSelf in the video, but with respect to your privacy, we only show the body feature in question so you are not personally identifiable. If you prefer not to have your video question visible on YouTube, please contact us.

Botox is certainly worth a try to give you a mild brow lift. However, you have a very prominent brow, and if the results are not satisfactory, you may consider a consultation with a plastic surgeon for surgical options.

Hello,Careful treatment with Botox can be helpful for many issues. I recommend that you work with an experienced Cosmetic Surgeon and treat conservatively, then gauge your results. All the best