18 units of upper forehead Botox 1.5 wks ago pushed my inner eyebrows down causing my eyes to look squinty w/ no eyelids.(photo)

The inner half of my eyebrows are pushed down, my eyelids are hidden and my eyes appear to be squinted. Called the MD and they said, "You only had 18 units! Nothing that can be done to lift your brows." I will not be going back there. I thought maybe other muscles could be injected to offset this. I called a plastic surgeon and even the person there sounded doubtful but reluctantly made me an appt. Is there anything that can be done to lift the portion of my eyebrows that are pushed down?

Doctor Answers 9

Forehead botox and brow position

The forehead is probably the most variably and poorly treated region of the upper face with Botox. It is important to balance the benefit of wrinkle improvement with relaxation of the only eyebrow elevator, the frontalis muscle, and resulting eyebrow droop that will occur. Dosages exceeding 20 units in the forehead are rarely warranted, in my opinion, because the trade of complete line effacement is not worth the side effect of noticeable brow droop. The key to success in forehead treatment is modest dosing (enough to soften the lines with minimal impact on eyebrow position). Fortunately, Botox is not permanent and your eyebrow droop should improve with time. A helpful way to help raise your brow is to inject botox into the corrugator muscles that pull the inner brow down, and the orbicularis oculi muscle which pulls the outer brow down. Prior to any intervention, however, a proper physical exam is necessary. I hope this information helps, and I wish you the best of luck.

San Francisco Facial Plastic Surgeon
4.5 out of 5 stars 13 reviews

Botox and low forehead

It appears as if a little too much Botox was injected somewhat low which caused your eyebrows to move down.  It will wear off in a few weeks but there is nothing to do right now.  Please consult an experienced board certified dermatologist with years of experience with Botox and cosmetic injections.  Best, Dr. Green

Michele S. Green, MD
New York Dermatologist
5.0 out of 5 stars 76 reviews

Botox brows

Thank you for your question.  It appears as though you had quite a bit of Botox injected into your forehead.  Typically we use about half the amount of units you had injected as the frontalis muscle is a very thin muscle that does not require a lot of botox.  The options are to wait it out as the botox will be metabolized in a few months (there is no way to reverse botox - which is typically why it is better to go conservative and add more at a touchup, a week or two after the initial injection) or try to counteract the muscles that are being affected by injecting the glabellar complex which would include the glabella and depressor supercilii.  Regards, Dr. Matt Elias

Matthew Elias, DO, FAAD
Fort Lauderdale Dermatologic Surgeon
5.0 out of 5 stars 5 reviews

18 units of upper forehead Botox 1.5 wks ago pushed my inner eyebrows down causing my eyes to look squinty w/ no eyelids.

Unopposed Botox injections of the forehead only could be teh reason for the brows to descend. I believe that this is the root of your concern. Botox could be injected to your Glabella and Crow's feet in order to decrease the pull down of these other 2 muscles and try to balance your brown into a higher position. The other option is to wait until the Botox wears off the forehead.

Hope this helps,
Dr. Gus Diaz

Gustavo A. Diaz, MD
Charlotte Facial Plastic Surgeon
4.7 out of 5 stars 15 reviews

Botox in the forehead causing central brow drop

Too much botox in the forehead can cause the brows to be lowered.  Although this is temporary, it can be distressing.  18 units is a very large dose for the forehead.  Potentially, you could get lift by injecting the in the glabellar complex to counteract the downward pressure of the forehead.  Seek out an expert injector.  If you are unhappy with results or having a complication, your physician should always be happy to see you and offer advice.  When in doubt always seek a second opinion.

Kyle Coleman, MD
New Orleans Dermatologic Surgeon
5.0 out of 5 stars 9 reviews

Medial eyebrow droop after Botox

18u is alot for just a forehead injection of Botox. There are a couple ways to correct this. As others have said, injecting the glabella will help. I rarely will inject forehead alone without injecting glabella. Also, injecting the the depressor supercilii will help elevate the medial brow.

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

Brow Drop with Botox Treatment

You were injected with a high dose of Botox to that region that will weaken the frontalis muscles. Those muscles work to elevate your brows and when they are weak your brows will drop. If you were not injected in the glabellar region then injecting the corrugator muscles (muscles in charge of pulling your brows downward and medially) then you maybe able to counter act the dropping of your brows. The good news is that it is temporary and usually by 2 to 3 months this should resolve.

Good luck!

18 units of upper forehead Botox 1.5 wks ago pushed my inner eyebrows down causing my eyes to look squinty w/ no eyelids

Appears as over injected in units to medial brows. Time will allow metabolization of the BOTOX, 3 to 5 months. If you can not wait than inner brow Silhouette Lift might elevate sooner but there would be a cost of $1,000. 

Darryl J. Blinski, MD
Miami Plastic Surgeon
4.6 out of 5 stars 173 reviews

After botox with inner eyebrow droop

The amount of botox you received to your forehead could definitely lead to this problem.  A helpful way to off set this would be to have botox injected into the corrugator muscles that pull the inner brow down.  This is the area between the brows often referred to as the 11 lines. I rarely inject only the forehead for this very reason.  You need to simultaneously elevate the brows when trying to soften the forehead lines.  Best of luck!

Katrinka L. Heher, MD
Boston Oculoplastic Surgeon
5.0 out of 5 stars 8 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.