Candyo, It is not unusual to need Botox Cosmetic after brow lift surgery. The need for repeat Botox injection is largely based on what was done during the initial plastic brow surgery. Eyebrow lift surgery not only lifts the brow, cosmetic surgery may also modify the forehead muscles. These same muscles are the ones treated with Botox cosmetic. Active muscles of the face create the dynamic wrinkles. Muscles which are weakened, removed, or cut will need less Botox, if any at all. Forehead and brow muscles may be modified with almost any surgical approach to the eyebrow: endoscopic, coronal, pretrichial, direct, transblepharoplasty, midforehead, or lateral brow lifts. Some plastic surgeons will inject Botox at the time of forehead surgery to help keep the eyebrow in good position. Speak to your plastic surgeon to help plan Botox cosmetic and your cosmetic Brow Lift.