Day 3 - Spock brow on the left, when shall I correct it?

Please watch the video below. I try to explain some key aspects of the technicalities of using or getting botox. Too much botox in the wrong muscles can cause issues such as this.  It really does make a difference who is injecting, how much and where it is injected. It is one of those treatments that unfortunately has become a commodity and it really requires a bit more of an artistic finesse approach ini my mind.  
We use the neuromodulators to target and soften the muscle groups without giving that frozen look.
Hope this helps,
Best of luck,
DrC

Sometimes after Botox of the glabella region of the forehead, between the eyebrows, the forehead tries to keep raising the eyebrows, but can't in the middle any longer and overcompensates and pulls more strongly on the outer forehead which can cause a peak of the eyebrow like Mr. Spock. As the rest of the forehead becomes more affected by the Botox injections in the first two weeks, the Spock eyebrow can settle down.I do encourage my patients to wait a week and a half to two weeks before adjusting a Spock eyebrow to see if it improves. Usually one unit placed in the right spot is enough to reduce the Spock eyebrow.

Day three tends to be when the toxin starts to work, You will see your end results at around two weeks. It can be normal to see some strange things happen to your brows on the first few days, but generally this will all settle down.  At your review your Dr will assess if additional toxin is necessary. 

It can take up to 2 weeks for final results after Botox. I would wait a full 2 weeks before assessing results and whether you need a touch-up. Hope this helps.

We presented a study at the Boston Meeting of ASPS comparing Botox to Xeomin in ten patients with Botox on one side of the forehead and Xeomin on the other side.  In those ten patients, all were paralyzed in by three days with a few in 24 and 48 hours.   Botox and Xeomin were found !00% identical in dosage, onset, and duration.  Asymmetries can be corrected with a touch up in 1 week in most cases.  

I would wait about 2 weeks after your Botox injection to see the result of your treatment.  If you still feel there is some difference between sides or a "spock" brow, I would return to the physician who treated you.  A touch up treatment can frequently be done to improve these issues.  

Thank you for your question miaomioa7. I understand your concern. Botox is a purified protein used to address wrinkles associated with facial expression. When injected into the skin Botox will relax the muscles and smoothen out the overlying wrinkles. The most common areas of treatment are in the upper face. These include the horizontal lines seen on the upper forehead when one raises the brows, the vertical lines seen between the brows when one frowns (frown lines), and the crow's feet seen around the eyes when one smiles.
It is difficult to make an assessment in the absence of consistent photographs before and after in the same lighting and angles for comparison. However, I hope the information provided here is useful.The appearance of frown lines is variable from person to person. Usually they are in a vertical orientation but sometimes they can be oblique and sometimes a horizontal line is seen across the upper portion of the nasal bridge. The most common variation is to have two parallel lines, hence the common term "11's" to describe them. But some people have one, three, or more lines. Some people also will see a bulge in the area when contracting the muscle. This bulge is smoothened out after a Botox treatment.
The pivotal studies used 20 units of Botox in the glabella area between the brow to address the frown lines. These studies demonstrated that the peak results are seen 14 days after the treatment and most people enjoy their results for 3-4 months. At that point, a maintenance treatment is recommended. While some people start to see results as early as the next day, it can take two weeks for full results so patience is important. We have our patients return two weeks after their treatment to assess their results via photographs. At that time additional units may be added if necessary. 
When patients present with concerns about specific wrinkles in the upper face such as the frown lines, I always assess and usually treat the other wrinkles in the upper face including the horizontal forehead wrinkles and crow’s feet. The reason is to maintain a harmonious and natural balance to the appearance of the upper face. The muscles in the glabella which are responsible for the formation of the frown lines serve to pull down on the inner brows when a person frowns. Similarly, the muscles around the eyes which are responsible for the formation of the crow’s feet seen when smiling (orbicularis oculi) are also responsible for pulling down on the brows, but in this case the outer brows. On the other hand, the muscle in the upper forehead which is responsible for the formation of the horizontal forehead wrinkles when a person raises the brows (frontalis) serves to pull the brows upward. If one of these muscles is relaxed with Botox and the others are not, the other muscles will still be active. This will lead to an unbalanced and unnatural appearance of the upper face where the brow can be elevated, depressed, or uneven in shape or position. Therefore, I recommend that my patients take a global approach to the upper face when receiving Botox treatments and treat all three of these areas. Sometimes bunny lines on the bridge of the nose are also treated.
Sometimes after a Botox treatment a peaked appearance of the eyebrow is seen. This is sometimes called the Spock or Mephisto look, which makes a person appear surprised or sinister. It is also called the Jack Nicholson look, after the appearance of his eyebrows. This can occur if the muscles that pull the eyebrow down are relaxed with Botox. It can also occur if the upper forehead only is treated. In this case the inner portions of the muscles are relaxed preferentially over the outer portions of the muscle. This allows the outer portions of the muscle to pull up on the tail of the eyebrow. While some people desire this appearance, others do not. This effect can be corrected by placing a small amount (1-2 units) of Botox in the upper forehead approximately midway between the eyebrow and the hair line at the peak of the brow. This relaxes the muscle that pulls up on the tail of the eyebrow, thereby restoring a natural appearance.
If I had a patient with the concern described here I would recommend waiting 14 days after the initial treatment to assess the results. At that time additional units may be added as described above.With any injection, there are risks such as pain, bleeding, bruising, redness, swelling, tenderness, and infection. We take special precautions to minimize these risks such as using a painless technique. We also treat bruises with a laser as early as the next day. Bruises usually resolve within two weeks if untreated. After a laser treatment bruises usually resolve in 1-3 days, but may still take two weeks for full resolution. In addition to these risks, with Botox there is also a risk that the product spreads or diffuses to nearby structures. Spread to nearby muscles can lead to side effects such as the temporary appearance of droopy eyelids or a temporary asymmetric smile.

After a Botox treatment, I recommend that my patients avoid heat exposure, alcohol consumption, and strenuous exercise for 24 hours and not lie down flat for four hours. This is because all of these activities may possibly lead to the movement of the product and consequent side effects such as droopy eyelids. Although there have been no definitive studies shown that these actually occur and some physicians do not provide such aftercare instructions, in the absence of data I err on the side of caution and recommend that my patients avoid such activities.

Please consult with a doctor for specific recommendations. Good luck!

If you are already showing signs of Spock brow I think you are fine to go back and have a small touch up ASAP.  It is not an uncommon occurrence to have occur and a really easy fix.  Enjoy your Botox treatment. 

Thankyou for your question.unfortunately you will need some patience . You should wait a full 2 weeks before returning to your injector as things may settle . its easily fixed if needed but i recommend you wait the 2 weeks. good luck

Hi Miaomiao7, thank you for the question.
I am so sorry your eyebrow did not cooperate with the botox you received!  My recommendation is to return to your provider for a few of units to touch-up the unwanted eyebrow "lift".  
Best,