Droopy Brow Correction After Botox by RN?

I've recently had my first experience with Botox, which was administered by an RN, and my brows have dropped. Having gained a very quick education, I intend to go to a reputable plastic surgeon in the future. The RN is unaware that I have experienced a problem. If the brow drop can be alleviated by injecting the antagonistic muscle, is it advisable to approach her for the correction, or would this be better left for the doctor?

Doctor Answers 4

Droopy brow correction from Botox

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I would NOT go back. We are not created equal; some of us are faster, others more coordinated, others more athletic etc.

These days EVERYBODY injects Botox and Allergan, Botox producers encourages it to make millions. But - thee is a lot of "Bad Botox" walking around out there because many injectors not only lack a fundamental knowledge of facial anatomy but it is compounded by misunderstanding of what YOU already alluded to the selective play of synergistic and opposing muscles.

In your case, you must have ALREADY been compensating for drooping eye brows. Injecting Botox within 2 cm of the brows weakens the Frontalis muscles to the point it literally lets go and the brows droop. A better result would have been obtained with selective Botox placement 3cm above the brows and weakening of the Corrugators (snarl muscles) and the Orbicularis Oculi (just below the side aspect of the Brows) - this will lead to a nice Botox brow lift.

Wait until the Botox effect resolves and go see a well trained Plastic Surgeon or another MD colleague who is skilled with this technique.

Good Luck.

Memphis Plastic Surgeon

With botox, often times less is more.

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The novice injector may not appreciate how important the forehead muscles are for keeping the eyelids open. This is particularly true in patients who have heavy upper eyelids and in older patients who need these muscles to keep their eyes open. Often times it is best to avoid putting botox in the forehead completely and to use other treatment like fillers to address this area.

Patricia Farris, MD
Metairie Dermatologic Surgeon

Treatment for eyebrow droops after Botox Cosmetic

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Botox Cosmetic is not one treatment, but a collection of potential treatments. Botox Cosmetic may be applied in specific ways to achieve certain results for facial rejuvenation.

Anyone who has received extensive training may inject Botox Cosmetic, physicians or nurses. Plastic surgeons or dermatologists are not the only ones able to provide treatment. Your child's pediatrician could give Botox too. Laws vary by state. Ultimately, it comes down to the injector's experience and training. Even the best injectors may get less than optimal results.

Eyebrow ptosis (droop) after Botox Cosmetic usually occurs from treating inappropriate muscle groups, and less commonly from slight migration of the medication from its original injection site.

Botox Cosmetic may also be used to raise the eyebrows. This non-surgical brow lift is achieved by injecting the the orbicularis muscle which pulls down the brow. Results are temporary, and may not be noticeable if you have severely droopy eyebrows. Surgical brow lift would be more appropriate for severe eyebrow ptosis.

Houtan Chaboki, MD
Washington DC Facial Plastic Surgeon
4.9 out of 5 stars 89 reviews

Don't go back

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Everyone who knows how to handle a needle seems to think they know how to inject Botox. It's not necessarily the injection that's the issue it's the evaluation of the patient before the injection. The age of the patient, current brow position, skin tone and other issues have to be assessed. Then and only then can the lateral forehead be paralyzed.

Five units of Botox under the lateral brow is normally how we elevate the brow because the forehead muscle lifts it. Now doing that will only make things worse. So the antidote is time and don't get your lateral forehead injected again.

You might consider a brow lift.

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.