Puffy eyes after Botox (Photo)

Question

I have had Botox about 8 times and on 2 occasions when requesting a lifted brow look, I have ended up with hooded eyes. I had Botox 3 weeks ago and went back for the top up 5 days ago and my brows has dropped. Is this likely to get worse before it gets better? I'm going on holiday in 5 days so I'm worried. I also have a funny bulge when I raise my eyebrows ( on one side by the tail of my brow). Will this last the full term of the Botox? Thanks

David Hill, MD · Answer

It looks like you have a "hook brow" in the photo, which is caused by treating the glabella and frontalis centrally and not treating the frontalis laterally. This results in a "Spocking" or "Mephisto" look of the brow where it is pointed, as it pulls only on the outside parts when trying to raise your brows. The inner part of the brow is lower because the frontalis is not pulling up there after toxin. You can treat the lateral frontalis to help soften the look, but the brow heaviness will likely last the duration of the toxin timeline, which is 3-4 months in total. Since you are now 4 weeks post-treatment, it will likely last another 2-3 months.

Camille Cash, MD · Answer

Botox is in full effect two weeks after injection.  The "spock" brow that it appears you have can be softened by treating the outer part of the brow.  The heavy lids will gradually improve as the Botox wears off.

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