Botox Touch Up Caused Brows to Lower, How Long Until I See Improvement?

I had a botox touch-up 8 days ago to my forehead to correct creases that formed over the outer brow whenever I raised my eyebrows.(had 20 units to forehead lines and 20 to frownlines 1.5 months prior). Doctor added 20 more units(seemed excessive) and now my eyebrows now have NO movement, my brow dropped/straightened and is very low. I'm afraid to get more botox,but I am a little desperate to fix this since we have an important trip in a week. Anything I can do?

Doctor Answers 11

Lowered brow after Botox touch-up...

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
First off, the good news is that your symptoms are likely temporary and in time, your brow will return to its pre-injection position...

A drooping eye-BROW may happen in the following scenarios:

(1) When the brow-elevating muscle in the forehead, the Frontalis, receives too high a dose of Botox.

(2) The Botox is sub-optimally placed too low in the forehead -- it should typically be placed at least 1 cm above the Brow.

(3) Over-injection of the glabella area (between the brows).

(4) It may also happen if you have a low set eyebrow to begin with, in which case any Botox to the Frontalis increases the likelihood of a brow droop.

Ironically, a droopy eye-BROW from Botox can sometimes be improved with MORE Botox -- this time, the Botox is typically injected into the outside (top of the crow's feet) part of the eye (aka the lateral aspect of the orbicularis oculi muscle) to generate a bit of a brow lift in that area -- by injecting more Botox and paralyzing the orbicularis muscle that normally acts to depress the brow in that area, you may get a slight compensatory brow lift...

If the extra Botox does not improve the brow droop, it will likely last as long as the full duration of the Botox -- 3-4 months.

In the future, please seek the services of an experienced physician injector.

I think the key with Botox lies in truly understanding the anatomy of the injected area, and more importantly the variability in the anatomy between patients -- for brows, the forehead, and anywhere else you plan on receiving a Botox injection. This includes having a firm understanding of the origin, insertion, and action of each muscle that will be injected, the thickness of each muscle targeted, how deep beneath the skin the actual muscle resides, and the patient variability therein. As an aesthetic-trained plastic surgeon, I am intrinsically biased since I operate in the area for browlifts and facelifts, and have a unique perspective to the muscle anatomy since I commonly dissect under the skin, see the actual muscles themselves, and learn "first-hand" the incredible variability between patients -- live, "on the OR table" -- as opposed to via lectures or a cadaver dissection. For me, this helps guide where to inject and where not to. However, with that said, I know many non-aesthetic trained plastic surgeons and other physicians who know the anatomy well despite not operating in that area, and get good results.

Good luck.

Dr Markarian

Botox to help eyebrows

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Botox cosmetic takes 3-6  months to wear off. This is why it's so important to know exactly what muscles to inject and what amounts of Botox to use in each area. Injecting a small amount of Botox into the muscles that pull the forehead down may help raise the eyebrows a little. These muscles are near the lateral eyebrows.

However, Botox takes several days to 2 weeks to work. If your trip is in a few days, the treatment will probably not work in time.


Yelena Frankel, MD
Baltimore Dermatologic Surgeon

Botox for forehead lines

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

If too much Botox is injected into the forehead, it will cause lowering of the brow.  More Botox at this time is not the answer.  You must wait until the Botox wears off in a few months.  Stimulation of the muscles with the Endolift by LPG is another alternative to the Pan G and may help elevate your brow more quickly.  Multiple treatments are required.

Please visit a board certified dermatologist or plastic surgeon for your treatments.

Martie Gidon, MD, FRCPC
Toronto Dermatologist

You might also like...

Need to wait

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

You need to wait until you have some movement in the forehead/brow elevation and then go back in to have a touch up (small dose of 2 to 3 units) in order to paralyze the brow depressors more allowing the brows to go up more.

Resolve Dropped Eyebrow from Botox

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

The bad news is that your muscle is temporarily unable to move. The good news is that it's temporary. While there are prescription eye drops that can help if it's actually the eyelid that's dropped or immobile, these drops will not help if it's actually the eyebrow that's unable to move. There is a machine called the Pan G which is like a workout for facial muscles. It's two probes that can be placed in varying locations on the face and generate a pulse that target the muscle to contract and release. If you can find a physician in your area that has this machine, it can help with dropped eyebrows and eyelids from Botox. I know very few doctors in the country that have it, but it does force the muscles to work again, and after a few short treatments (usually 3-6 treatments that are 5 min or less), your muscles are able to move again and can help lift the eyebrow back up.

Too much Botox to forehead - is there a remedy?

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Dosing the forehead requires meticulous technique with placement and proper dosing to avoid what you are describing.  With a forehead muscle that is too relaxed, your "compensatory mechanism" (the ability for you to lift using this muscle) has been taken away...temporarily. 

As other panel members suggested, this should improve with time as the effects gradually wear off.  Using the lateral brow technique to try and help this situation may or may not help.  Even if it does help, it will only benefit the lateral (side) areas of the brows which may accentuate the negative effects everywhere else. 

We encourage you to report this to your injector so that they may offer feedback and document your chart accordingly.  If you see value in your relationship with this practice, let them have an opportunity to take care of you. 

Harold J. Kaplan, MD
Los Angeles Facial Plastic Surgeon
4.4 out of 5 stars 7 reviews

Fixing a dropped brow

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

At this point, if the brow is completely knocked out, it is very difficult to impossiblt to raise it. Sometimes the tail or lateral brow can be elevated a bit by injected just below the eyebrow laterally to treat the orbicularis oculi muscle.  Otherwise, you have to let it wear off.

Botox and brow drop

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

I think you are going to have to wait until you get some movement back in your lateral forehead area.   Then you can have a tiny amount of Botox ( 1-3 units) injected in the brow depressor muscles, but you must have some movement back to lift the brows.  The good and the bad with Botox is that the effects are temporary!

Sheri G. Feldman, MD
Beverly Hills Dermatologist

Botox dropped Brow anything I can do?

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Botox dropped Brow anything I can do?  Yes, you can go back to the MD that did the Botox and see if they're willing to even things out.  You can actively try and raise the brows as well as close the eyes which will work all the muscles.  This tends to make the Botox wear off more quickly.


{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

This is a placement and dose question. I never use that much Botox for touch ups. Your lifting muscle has been completley paralyzed. Adding Botox to the depressor muscles may help but, i doubt it. You have no lifting power.

David A. Bray, Sr., MD
Los Angeles Facial Plastic Surgeon

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.