Uneven Eyes 2 Days Post-Botox

Question

Botox Newbie, Second Day and I Am Nervous About Results. I had 60 units of botox injected in my forehead two days ago and I have noticed my right eye is a bit higher then my left. It's not extreme but I don't like it. Can my eyes still even out or do I need to go back to my doctor today?

Ron Shelton, MD · Answer

60 units is a lot for the forehead. You may see continued sinking of the skin of the forehead, bringing with it the eyebrows to a lower position and then the eyelids.  Depending on exactly where the Botox was placed, there might be hope to elevate the forehead by injecitng the depressor muscles. Your treatment hasn't peaked yet, in two weeks there is usually the maximum effect noted.  Then, your doctor will know better what to do to make your appearance the best it can be.

Stephen Prendiville, MD · Answer

The amount of Botox used depends on the indications and the actual patient.  Although 60 units would be a large dose in the frontalis muscle (horizontal lines) ina  female patient, 60 units injected into the corrugator muscles (lower central brow) and frontalis would not be considered a large dose in a man.  The result takes 3-7 days to manifest in the majority of patients and you are likely to see further changes in the appearance of the upper third of your face.  Treatment of the frontalis muscle may cause your brow to drop slightly, given that this muscle functions as a brow elevator.  In fact, in certain patients, use of Botox to lift the tail of the brow is indicated when treating the frontalis muscle.

Kenneth D. Steinsapir, MD · Answer

60 units is a BIG dose for a BOTOX noob.  Expect the forehead to be paralyzed with a dose of this size.  This means that your forehead will droop.  This drooping may be symmetric or asymmetric.  However, at two days, it is impossible to know what your ultimate treatment effect will be.  At 5 days and 10 days you will have a much better understanding.  I would push out seen your doctor as a this moment there is nothing to be done.  However, if you are still having an issue a week or more out, then it is worth while to see your doctor.

Martie Gidon, MD, FRCPC, FAAD · Answer

Your Botox is just starting to take effect at 2 days.  It takes 12 days to see the full effect.  You should return to your doctor at 2 weeks to be reassessed.  You probably did not have 60 units of Botox since it is a large dose for a forehead, so you may have had another neuromodulator.

	Make sure you are treated by a board certified dermatologist or plastic surgeon to ensure the best possible results.

Gary Goldenberg, MD · Answer

This is normal. Wait 2 weeks. Then, if it's still not even, see your doctor for a touch up.

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