Do I Run the Risk of Eyebrow Drooping if I Have Botox Injected in Glabella?

Question

Im getting married next month and decided do botox in glabella. Ive read that is safer because there is minimal risk of eyebrow drop or any other complications. Does injection of botox in glabella can cause any major complications, Im concern as Im getting married and want look my best.

Ron Shelton, MD · Answer

If this is your very first botox treatment and it's only a month away from the wedding, you are taking somewhat of a chance. Not that anything serious will occur medically, but you have not had a personal experience with a particular physician who has given you Botox so you don't know how the physician will do, nor how you will respond. Look at the worst case scenario. If you had a very unusual side effect from the Botox or the physician was not as experienced as they should be in the delivery of Botox, you might develop unequal eyebrow levels and depending on the placement of the injections, even a brow drop or eyelid drop which could be impossible to fix for the wedding photographs. That said, it is very rare to cause a droop when only the glabella is treated but is it worth the chance that you get a temporary disfigurement right before your wedding, one that will go away on its own but could take months?

Harold J. Kaplan, MD · Answer

Hi Korki.  The answer to this question would depend for us on whether you have an injector that knows you already.  In our practice, we always being a first time patient back for a 2 week checkup to make sure that the patient is completely happy and that the injection went as planned.  This allows us to be a bit more conservative on the front end of the treatment program and allows us to get to know how our patient reacts to the treatment (how many units are ideal).

	If you do not have an injector that knows you already, then we would recommend finding an experienced one or one that uses this kind of approach.  The last thing you need is for a new injector to be careless or cavalier right before your wedding.  This is a trusted relationships you are developing so proceed with caution.  Good luck.

Kenneth D. Steinsapir, MD · Answer

However, the BOTOX service can be safely performed.  The key is finding a very experienced injector.  This is not the time to save some money and go to someone who does not know what they are doing.

Steven M. Lynch, MD · Answer

Botox injected in the glabella is a great way to prevent the frown lines during normal conversational facial animation. 

	  It would be very rare to get any effect on the levator muscle (the muscle that opens the eye) by any injections in this area unless the patient rubbed the area hard and had the product migrate to the levator.  Even in this situation, it would be very unlikely.

	  Make sure you go to a skilled injector and you should be fine.

	               Steven M. Lynch, M.D.

Cameron Rokhsar, MD, FAAD · Answer

It is very rare for Botox in the glabella to change the height of the brow. However, I tell almost ALL my patients to put off anything right before a wedding. If you were 7 months from your wedding, I would say absolutely, go for it. But you can't risk being unhappy with your appearance on your wedding day, it simply isn't worth it.

Barry L. Eppley, MD, DMD · Answer

While eyelid droop after the injection of Botox into the glabella is a possibility, it is fairly rare in that area. That risk is greater when injections are done across the top of the eyebrows. If you go to an experienced injector and limit the Botox injections to the glabellar area, you should be just fine for your wedding day.

Steven Wallach, MD · Answer

Injecting botox on the glabella region will treat the corrugator muscles which bull the eyebrows inward and downward. This can lead to "11" lines and an angry scowl. If done properly it should not cause eyelid droop.

Fereydoon S. Mahjouri, MD · Answer

If Botox is injected by an experienced and trained surgeon in appropriate sites, you should not worry about droppiness of your eyebrow(s). However there is always remote possibilities of having some transient complications. It may be helpful to ask if your injector ever had encountered such a complication and how did he/she handled them ?

Herluf G. Lund, Jr, MD · Answer

Dear Korki,  First congratulations on your big day!  I understand your concern to make it as perfect as it can be and thus your worries about Botox.  Botox is a very safe drug and most patients love their results.  Most complications of Botox have nothing to do with the front end of the needle but instead come from the back end; that is the side the injector is on.  A skilled and qualified injector can determine if Botox is the correct solution to address your concerns.  Treatment of the glabella region requires identifying the exact position of the muscles causing the undesired wrinkles and then determining the correct dose for paralyzing those muscles to obtain the desired result.  Mal-placement of the Botox can cause a mid-eyebrow droop and also rarely cause eyelid droop but these are very rare complications.  

	Please do your homework and research.  Look for a very skilled and qualified Botox injector.  Also, I think two weeks before your wedding should be enough time to allow you to have your Botox treatment and be all set for the big moment.  Again, congratulations and I wish the both of you a long and happy life together!

Syed Amiry, DO · Answer

Generally injection of botox in glabela does not cause droopiness in the eyebrow, but in rare cases patients HAVE REPORTED drroopiness. The risk is low to zero however. So, I would go ahead and have your botox done.

Do I Run the Risk of Eyebrow Drooping if I Have Botox Injected in Glabella?

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