Bulging 11s after Botox. Is there anything I can do?

Question

I had Botox a week ago and now my area 11 is drooping down, which makes my eyebrows look like the grinch. I have to pull my eyes up to put shadow on. They look small from all the bulging between my eyebrows. Is there anything I can do?

Scott Trimas, MD · Answer

I would go back to your provider with your concerns. Typically, the results are temporary and should resolve with time. Alternatively, additional botox to the high forehead and central forehead might result in additional improvement and elevation of your eyebrows.

Anil R. Shah, MD · Answer

Medial brow ptosis or descent of the central brow can occur for several reasons:

-Botox placed too low within the frontalis muscle along the forehead including central forehead.  The frontalis muscle elevates the forehead and by decreasing activity here the central brow can drop
-Botox placed too superficially along the corrugator.  The botox will again impact the frontalis muscle and paradoxically lower the central brow.
Botox is best injected by an experienced injector to lessen wrinkles while improving facial appearance.

Chad C. Zatezalo, MD · Answer

Its likely that the botox injection also targeted muscle fibers of the frontalis muscle.  Addition botox in the correct area may help.  I would most likely wait it out and find another injector and ask to be injected conservatively.  If you are a skinny women with low muscle mass, you dont need as much as a heavy brow you may see on some men.  Good luck.  Dr Z

Sean R. Weiss, MD, FACS · Answer

It sounds like you are having the middle part of the brow droop.  This can happen when the botox injections are placed too high and the forehead muscle is weak.  You should discuss this concern with your injector and adjustments may be needed with future treatments.  Botox will last for 3-4 months and then muscle function returns to normal, so you can expect that this condition will get better with time.
Best Regards, 
Dr. Weiss

Jason Emer, MD · Answer

Keep in mind, it can take 1-2 weeks for final results with Botox. If you're unhappy with your final results, venus legacy treatments can give improvement. Best, Dr. Emer

Nelson Castillo, MD · Answer

Thank you for sharing your question.  It is difficult to offer definite advice without a series of photographs but typically injection of the 11's will maintain brow position and not cause them to fall. I would see your injector to assess your results and to see if there are options at treatment to improve your current appearance.

Faiyaaz Kalimullah, MD, FAAD · Answer

I'm sorry to hear that you aren't pleased with the results of your Botox treatment.  It's difficult to make exact recommendations without assessing you in person, or at least reviewing your photos.  That said, from your description, it sounds like you may be experiencing medial eyebrow ptosis.  This occurs when injectors either place forehead injections too low, or injections for the "11 lines" too high - as a result, the lower forehead is paralyzed, causing a droopy central brow.  Please keep in mind that it can take up to two weeks to see the full results of a Botox treatment.  I would recommend waiting another week and then following up with your injector to discuss your concerns.  I hope this helps.

Shaun Patel, MD · Answer

Typically, the eyebrows should not droop when treating the frown lines. I recommend you followup with your injector to discuss your concerns as it is hard to give you advice without evaluating you in person or seeing a photo.

Melvin Elson, MD · Answer

Although it is difficult to assess without seeing you it sounds like the Botox was placed too low and that is why the drop is occurring.  it will take some time to go away but see your doctor to see if anything can be done

Leonard Grossman, MD · Answer

In order to in order to be able to answer your question appropriately you should submit either a good set of photographs or be evaluated in person. Good luck from New York City

Bulging 11s after Botox. Is there anything I can do?

Answers (12)

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