On Day 6 Post Botox, the Area Under my Brow Bone is Puffy and Slightly Swollen? (photo)

On day 6 post botox the area under my brow bone is puffy & slightly swollen. Last Wednesday I had 32 units of botox in my forehead, between my eyebrows & around my eyes. The area all around my eyes feels heavy and tired & has slight pressure. Will this get worse before it gets better? With everything I am reading I am worried that by day 10 my eyes will be swollen shut! Is the worst yet to come or will it just get better from this point on? Is there anything I can do to prevent it from getting worse?

Doctor Answers 3


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That is a very good question. All of the neurotoxins take time to work and the results are not instant. You need to give the injections at least one full week. The duration of treatment is approximately 3 months.

Palm Harbor Plastic Surgeon

Botox and heaviness

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Based on your photo's, it's difficult to tell exactly how much swelling there is, however from what you've described, it sounds like what you are feeling is typical. Botox can set up firm, then soften up. Give it up to two weeks and follow up with your provider if you need further clarification.

Sam Naficy, MD, FACS
Seattle Facial Plastic Surgeon
4.7 out of 5 stars 231 reviews

Fullness under brow bone = Youthful appearance

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Hi Twink1,

The results of the Botox are as expected for having Botox injected. It should not get any worse.  As the botox wears off, you will start to raise you eyebrows and also show more upper eyelid.

We don't know what you look like prior to the Botox, but my guess is that you were slightly raising your eyebrows, and you had more upper eyelid showing.  However, since you were raising your eyebrows subconsciously (the reason you had horizontal forehead wrinkles), you also showed more upper eyelid.

The botox has already relaxed your forehead.  The muscle can't get anymore relaxed, so the amount of upper eyelid should not reduce any further.  For an older person, the forehead botox can make them "hood" or have skin hanging over the outer part of the upper eyelashes.  Since you are young, this is not happening to you.

The main reason you are having the fullness below the brow bone and above the upper eyelid fold/crease is that you are temporarily not able to raise your eyebrows.  This does make your forehead smoother, but it also shows less upper eyelid showing.

In general, people have"puffier" eyelids when they were younger.  If you look at your high school yearbook or photos when you were even younger, you probably had about the same amount of upper eyelid showing as you currently do. 

Take a look at fashion magazines how much upper eyelid these models show.  Some models have very deep set eyes, like a young Sophia Loren, and higher eyebrows, while other models have very little upper eyelid showing like Claudia Schiffer, with a low relaxed brow and nearly no upper eyelid showing.  Everyone else is somewhere in between.  

Your eyelid and brow configuration is not a deep set type of eyelid, which is why you only have a little bit of upper eyelid showing.  The Botox is simply returning you to a more relaxed state which is most likely closer to how you looked when you were younger.  

Sometimes as we age, we start contorting our faces.  If you remember an old saying by mothers, aunts or grandmothers, "Don't make faces, your face will stick that way."  They were hinting that if you keep squinting, frowning or raising your eyebrows, that wrinkles will form and it makes you look like your face is stuck that way (constantly squinting, frowning or forming horizontal forehead wrinkles.)  When these lines and wrinkles etch into the skin from repetitive facial expresions, they become present even when you are not actively squinting, frowning or raising your eyebrows.  These lines can make a face look older.  A young face can make a facial expression, but when they stop, their face is wrinkle-free.  

I hope these points make sense in regards to your questions and concerns.

While on the subject of facial rejuvenation and I wanted to mention a couple of points regarding my philosophy.

Often times the celebrities we hear about with bad plastic surgery have their eyes converted from a naturally puffier appearance to a hollow deep set type of eye, and completely change their appearance (e.g. Kenny Rogers, Wayne Newton.)

My facial rejuvenation philosophy for eyelids is to try to "maintain" the amount of upper eyelid showing in a similar amount to their "ideal appearance" which some where between their 20's to 40's.  Some people look better and more handsome or beautiful at a certain age and that age may not be 21, it could be 30 or older, and I try to use that as the template when choosing the right facial rejuvenation procedures to recommend.  

It is not competition of "how much" skin you can remove, "how tight" you can lift the face, "how much" eyelid you can show, "how much fat you can remove, "how much" filler or botox you can inject.  Faces are 3 dimensional, contours of faces have volume is the 3rd dimension and the skin covering is 2 dimensional.  Simply adding volume only or only tightening the skin may not be a good match to their younger selves.  Some people end up with pillow faces from too much fillers or fat grafting, while others look tight, surprised and wind-blown from too much surgical lifting and tightening.  

Thank you for posting your question.


Dr. Yang 

George Yang, MD
New York Facial Plastic Surgeon
4.8 out of 5 stars 35 reviews

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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.