I'm having muscle spasms between and right above my brows 5+ wks post Botox, esp when I wipe or rub the area. Is this normal?

My injector (a PA, 14 yrs exp) did 20 units between brows. Within 4 weeks I regained a good bit of movement. About 5 1/2 weeks I started having muscle spasms. If I touch or wipe the area the muscles seize up and appear contracted/lumpy. When I returned she added 15 more units and said she would contact Allergan - she had never heard of this reaction. Haven't heard back and the spasm is still happening after additonal units. Have you ever heard of this? And if so, what is going on??

Doctor Answers 6

Botox results and muscle recruitment

Sorry to hear about your experience. Often times, when one muscle or part of a muscle is treated with Botox, the body will recruit other muscles or the untreated part of the muscle to do the work of the treated muscle. When this occurs, it can result in muscle contractions such as what you describe. This can be easily treated by Botox injection into the recruited muscles. See an experienced injector and they should be able to resolve your issue.

Miami Physician
5.0 out of 5 stars 60 reviews

Post Botox Spasms -- Other Muscles May Be Recruited and Should Be Treated

It sounds like the muscles around your brow are trying to compensate for the Botox in the treated area. This should be easily remedied with injections in the frontal. Please find a board-certified dermatologist for this. Best, Dr. Emer

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.8 out of 5 stars 196 reviews

I'm having muscle spasms between and right above my brows 5+ wks post Botox, esp when I wipe or rub the area. Is this normal?

Thanks for your question and we always recommend that you consult with a board certified dermatologist or plastic surgeon as we are the true experts in this field and understand the anatomy of the area better than anyone and can usually determine what is going on and what may need to be done.  In your case, you probably are recruiting other muscles and this may be why this is happening.  Usually treating this is not to complicated and you may need additional toxin elsewhere to take care of the recruited muscles.  Finding the right provider here is important – you don’t necessarily want to keep putting toxin in the same places – but this can be determined with a good examination.

Michael Gold, MD
Nashville Dermatologic Surgeon
4.0 out of 5 stars 18 reviews

Spasms avfter Botox

The 20 units for the glabella is standard but often there is recruitment from adjacent muscles from the frontalis and others and these should be injected to correct the spasm. Just show the injector where the spasm is and have that injected for correction

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


It appears from you r description that additional Botox is needed in the forehead to stop the contracture of the frontalis muscles. 

Hratch L Karamanoukian MD FACS

Hratch Karamanoukian, MD, FACS
Buffalo Phlebologist
4.8 out of 5 stars 41 reviews


As you mentioned 20 units for treatment of the corrugates is the standard recommended dose for glabellar lines.  If the treatment wore off to soon that is concerning.  With additional product it is even more strange because of how effective Botox treatment for muscle relation.  If these spasms are in the forehead musculature the frontalis could be added to the treatment area as well.

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