Is it possible to achieve a brow lift and softening of the 11's without any medial brow drop? (Photos)

Thank you for sharing your question and photograph.  I would recommend limiting the amount of Botox placed between the brows while ensuring placement within the muscles and not into the one controlling your forehead.  Hope this helps.

As we age, our eyelids naturally sag and droop. A combination approach would be best to see visible improvement. In terms of non-surgical treatment options, I would recommend a Chemical Brow Lift (using Botox, Dysport, Xeomin, or Jeuveau) and filler injections to rejuvenate the temples, eyebrow, eyelid, eye troughs, upper eye hollows, and forehead. I typically combine this with Ultherapy and thread lifting to lift the brow; RF and skin tightening laser treatments to stimulate collagen production and rejuvenate the skin; and laser or superficial RF devices for improvements in texture, color, and any crepey skin around the eyes as needed. In some cases, surgery is the best solution to achieve the desired results. See an expert for a formal consultation. Best, Dr. Emer.​

Thank you for your question and I am sorry you have not seen optimal results from your Botox treatments thus far. Although this is a common cosmetic treatment, it requires a tremendous degree of precision in placement and dosing to achieve the best outcome. The medication targets the facial muscles that lead to the formation of wrinkles, and the right muscles need to be treated to ensure a natural look. A board-certified plastic surgeon who is also a Botox expert has the knowledge of facial anatomy as well as the artistic eye necessary to achieve the right result for you. 

Thank you for sharing your story.  You are describing what several patients can potentially experience.  To reduce adverse outcomes with Botox injections I suggest that you see an experienced injector who is either board certified in an accepted medical board specialty (not board of cosmetic surgery) or supervised by someone who is board certified as there are some excellent nurse and PA injectors.  You should also stay with the individual who does get it right with you.  You now know that when your glabella muscles are weakened (currugator and procerus) your frontalis muscles are unopposed and therefor you need a little Botox injected into the frontalis to avoid the "spock look".  Make certain that the procerus muscles are injected and you should avoid medial brow depression. There is no substitute for anatomical knowledge and experience.

Treating glabellar "eleven lines," forehead "worry lines," and nonsurgical browlifts with Botox (as well as other neuromodulators, such as Dysport and Xeomin) is nothing new. As with practically all nonsurgical injectables, including fillers, Botox was pioneered by dermatologists who went on to teach other core specialties, such as plastic surgery, opththalmic plastic surgery, otolaryngology, etc the required techniques. The results you are looking for and the injection techniques to achieve them are routine these days among the core aesthetic specialties. I have personally been injecting Botox for aesthetic reasons since 1991. So, what you need to do is simply to do your due diligence and find a board certified physician with the necessary experience and expertise and make sure to ask to see his/her personal befores and afters before agreeing to proceed. You shouldn't need to ask for anything other than the results you desire; your physician is the one who needs to know how to achieve those results, and if not, you would be well advised to look elsewhere. Best of luck. 

Every patient may need small, individual deviation from Botox application in the forehead and around eyes. A person who is treating you should be able to evaluate distribution and interplay of forehead/periorbital muscles in order to achieve desired result. It may take few applications and small corrections (7-14 days after Botox application) to find a pattern that will satisfy your needs. Knowledge of the underlying muscles anatomy, distribution and individual variations is very important. Good luck.

It is important that you have an injector that knows their anatomy. I would recommend seeing a board certified plastic surgeon with experience in facial cosmetic surgery and injections. You can elevate the brow with botox by injecting the corrugator muscles medially and the orbicularis muscle laterally at the Crow's feet. This will allow the frontalis muscle to elevate the brow unopposed. It is important that the injector not inject the frontalis if you want to elevate the brow and avoid the Spock brow. 

The purpose of a good forehead lift is to reduce the horizontal lines, eliminate the frown lines (elevens) and raise the eyebrows, both medially and laterally, more on the outer and less in the inner positions. It can be done through endoscopic, through the eyelid or an open technique, depending on the individuals anatomy. A long forehead can also be shortened. 

This is the classic manifestation of "bad Botox".  Yours is certainly subtle, but in some cases the medial brow will be completely immobile, and only the lateral brow will move, causing dramatic peaks.  What happens is that the injections placed in the muscles between the eyes (glabella) are placed too high above the brow and the frontals becomes affected.  Without the frontalis holding the brow up medially then the brow drops.  The injections in the glabella need to be placed right at the brow.  Frequently when i inject patients for the first time who have had Botox elsewhere, they are surprised by the placement of my injections.  Your injector should know this, but many don't.  You can either try and explain this to your injector (which you shouldn't have to), or you can try somewhere else.  I will say that some patients anatomically are more prone to this issue with Botox than others.  This is the art of Botox to some extent....

Thanks for the question.  It seems as though you have treated the corrugators  (11’s) which bring  the brow down and in a bit and the entire frontalis, which is the only muscle that raises the brow.  This inactivity of the frontalis  actually does not allow it to move up, so it hangs lower and feels heavy.  Try injecting the corrugators and the entire forehead, but well above the brows. Good luck!