Is it normal for eyelids & brow to sag for a few wks before you can see the intended improved effects of botox brow lift?(photo)

I did botox injections 5 days ago along my forehead and 4 right above the brows. I am 35, never had botox. My lines are mild/medium, very little sagging in eyes/brows. The problem is now lids are sagging, and eyebrows have lost the high arch. My doctor told me that the area will sag before it looks lifted and give it two weeks. This seems very counter-intuitive. Normal to look saggy before it not only gets back to normal but better than before? Should there be injections above the brow line?

Doctor Answers 9

Heavy brow after Botox

Thank you for your question autumn ebersold. I am sorry to hear about your situation. Botox is a purified protein used to address wrinkles associated with facial expressions such as the horizontal lines on the forehead seen when one raises the eyebrows. When I perform Botox injections in this area I keep the injection points high on the forehead. If the Botox is placed to low, a heavy brow can be felt and seen. It is also important to follow the aftercare instructions. I recommend to my patients to avoid heat exposure, alcohol consumption, and strenuous exercise for 24 hours after the treatment and avoid lying down flat for 4 hours after the treatment. Any of these can cause movement of the Botox and lead to side effects such as a heavy brow. Please follow up with your doctor for specific recommendations. Good luck!


Encino Physician
5.0 out of 5 stars 1 review

Botox causing eyelid or eyebrow drooping

The dropping eyelids and flattened eyebrows you describe indicate a complication of the Botox treatment. This complication usually results from injecting too much Botox into the forehead and injecting to close to the eyebrows. Since you have already visited the person who injected you and that person did not properly address the complication, I suggest you visit another physician, preferably someone who does a lot of Botox injections and knows facial anatomy. I am available by real self to answer any other questions you may have. 

Dr. Patel

Botox Can Smooth Forehead Lines & Help To Restore The More Youthful Arch To The Outer Third Of The Eyebrows

I have been using Botox for aesthetic reasons since 1991, eleven years before it even received its FDA approval for this. In the quarter of a century of its use in nonsurgical facial rejuvenation, it has become clear that the results of treatment with Botox are very much what we call in doctor lingo "operator dependent."  What this simply means is that the outcome of Botox treatment is very much determined by the level of experience and expertise of the person injecting it.

The desired effects of treatment usually occur anywhere from between one and seven days (occasionally as long as two weeks) following appropriate treatment. This is when you can expect to see smoothing of the forehead and elevation of the lateral brows.

Sagging usually implies too low a placement of the Botox over the brow leading to ptosis. Happily this untoward effect will usually wear off spontaneously over the next couple of months.  After that, I suggest you vet any potential treating physician. Look for someone board certified in a core aesthetic medical specialty such as dermatology and plastic surgery, and make certain to ask to see his/her before and after photos.

Nelson Lee Novick, MD
New York Dermatologic Surgeon
4.8 out of 5 stars 24 reviews

Drooping Eyelids / Eyebrow After Botox

I suggest seeing an expert if you have eyebrow or eyelid drooping after botox as this will take 2-3 months to resolve, but luckily will fully resolve as botox treatment is temporary. Having an injector with experience is the most important. Best, Dr. Emer.

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.9 out of 5 stars 168 reviews

Ptosis after Botox

There should be no drooping after the injection and prior to the effect of the Botox.  if it was injected too low or if you massaged the area, this could be the reason. It will eventually look better as the Botox wears off

Melvin Elson, MD
Nashville Dermatologist
5.0 out of 5 stars 6 reviews

Brow ptosis after Botox

If they are sagging after injection, they won't improve until the Botox starts to wear off in about 6-8 weeks. Poor placement, too much Botox, or using Botox in poor candidates is the reason for this problem. It seems the injector might not be extremely experienced.

Steven F. Weiner, MD
Panama City Facial Plastic Surgeon
4.6 out of 5 stars 27 reviews

Botox eyebrows

You eyelids and eyebrows should not sag unless some Botox diffuses to the eyelids. This could happen just be too much exertion or rubbing the injection site few hours after the injection. This is a temporary problem that resolves itself

Sagging eyelids and Brows after Botox

If properly injected, Eyelids and eyebrows should not sag from the beginning and by the end of first week the full lifting effect should be present.  It should never drop unless it's injected in the wrong muscles. The good news is that within four months the effect will wear off and your eyelids and brows will go back to their pre-injection position.

Darab Hormozi, MD
Towson Ophthalmologist

Should the eyebrows sag following Botox injections?

Thank you for sharing your concerns. When performed properly for brow-lift, Botox injections should raise the eyebrows within a week and last for 3-4 months. Your eyebrows might return to the normal height again in a month, but will not go up higher than that. I hope this helps. Always have experienced injectors perform your treatment.
Good luck,

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.