Could my muscles be responding to the Botox at a different pace? (photos)

I had my 1st botox treatment 3 days ago at a reputable dermatologist office, for my "11" lines. I noticed today that one brow appears higher than the other at rest. Neither brow is unsightly, just uneven. Could my muscles be responding to the botox at a different pace and slowly balance out over the next week or is this most likely something that I will have to get corrected? I waited 5 hrs before laying down and didn't rub injection sites. Strong frowning still remains possible as well.

Doctor Answers 7

Delayed BOTOX Cosmetic Results

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Hello, and thanks for your question! Muscles do, in fact, occasionally respond to BOTOX Cosmetic treatments at different rates. Three days after a procedure is still too soon to see final results, so give your self some time — usually about 10 days — before pursuing correction. Your results will likely even out. Keep in mind that nearly all faces have some degree of asymmetry. While a BOTOX Cosmetic treatment may amplify that asymmetry, you might just have noticed it because you're paying more attention to your face. Good luck!

Tucson Dermatologic Surgeon
5.0 out of 5 stars 4 reviews

Botox Injections and Response

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Botox injections take two full weeks to see the effect.  It is possible that each side is responding a little differently.  I would wait two weeks and then if it is uneven you should return to your treating physician to correct the problem.

Botox effects

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  • The average time to respond to Botox is 5 days.
  • The range is 12 hours to 2 weeks.
  • Give it a bit more time and if at 2 weeks you don't like the result, see the doctor who treated you. Best wishes.

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Timing of Botox Response

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Three days is too early to evaluate your response to Botox. Wait until the two week mark and then have a look and decide

Jo Herzog, MD
Birmingham Dermatologist
4.8 out of 5 stars 20 reviews

Muscle response to Botox

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Some muscles take longer to respond to Botox than others, so yes, you can have some areas responding now and others responding soon. That's why we tell people not to worry or get any touch-ups for at least 10 days. Things can change. Remember though, that like Dr. Chong pointed out, almost everyone has asymmetry, just like your brows before the treatment, so those can continue their asymmetry unless something was done to compensate for this during treatment.

"This answer has been solicited without seeing this patient and cannot be held as true medical advice, but only opinion. Seek in-person treatment with a trained medical professional for appropriate care."

Preinjection pic demonstrates your left brow has a better arch

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I usually point out facial asymmetries, before administering Botox and/or fillers with patients.  The first pic shows that your left brow has a better arch, at baseline.  Once the inner brow (corrugator) muscles are 
treated, the brow position will appear to elevate but asymmetries will also be magnified and require 5-7days to develop.  If the "11"s (vertical lines) persist after a week, you may want to notify your injector so additional product can be dosed.  The function of the "scowling" muscles is to "knit" the inner brows together and down.  Once the blockade is set up, you should anticipate the inner brows to splay open and the outside
brows to elevate.  Hope this helps. 

Lavinia K. Chong, MD
Orange County Plastic Surgeon
4.8 out of 5 stars 59 reviews

Wait two weeks

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You should wait for a full two weeks before you assess your results, since it can take this long for the Botox to work.  

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.