Glabellar Lines and Lower, Narrower Eyebrows After Botox Migraine Injections?

Question

I have been getting botox injections for migraines for at least 8 years. I have my dermatologist do the injections. He injects the area between my eyes and above my eyebrows and in my forehead. I have never had a problem before. And it does help to reduce the frequency and severity of my migraines. About six months ago, I began to notice vertical lines in both my eyebrows. And the area around the lines are lighter in color. My eyelids do not droop, but my eyebrows seem to be lower and less wide. Are the injections causing this?

Jason Emer, MD · Answer

For unique cases where a variety of modalities could be used to treat the condition, I would suggest an in-person or virtual consultation to develop a custom and effective treatment plan.  It is difficult to precisely define the best option without collecting the same information. I suggest reaching out to an expert for a consultation with surgical and non-surgical methods to get a comprehensive option. Best, Dr. Emer.

Steven Wallach, MD · Answer

The botox will works very well to soften the central glabella crease lines from deactivating the corruagtors, but you may be seeing recruitment of the lateral orbicularis that is causing those other lines.

Christopher L. Hess, MD · Answer

Botox injected between the brows paralyzes the corregator muscles and the procerus muscle. Botox injected into the forehead paralyzes the frontalis muscle. The remaining muscle in the area is a obicularis oculi or the donut shaped muscle that surrounds the eye. This muscle contracts causing the eye to close. Above the eye the muscle will cause vertical wrinkles. As far as the lighter color I can't say but it is fascinating. Maybe you should consider another treatment for the migraines. Paralyzing the obicularis muscle in this area could be detrimental to eye closure.

Scott E. Kasden, MD, FACS · Answer

If you really look at your pics, the lower one demonstrates that the eyebrows are down, and the upper lid skin is more reduncant.  This is the result of the treatment and will improve over time.  Show the doctor the photos, and next time a different injection technique should help prevent this.
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Mary P. Lupo, MD · Answer

You are getting recruitment from the lateral obicularis oculi muscle. That is causing the new lines I see in the brows. The Botox is migrating into the medial and inferior frontalis muscle from the corrugator injection, resulting in a medial brow drop.
Go see your injector and they will know how to correct this.

Glabellar Lines and Lower, Narrower Eyebrows After Botox Migraine Injections?

Answers (5)