I want to raise droopy brows/lids. How much Botox is needed, and where?

I have brow ptosis, particularly on the left side, and worse "11" lines on the left. I want to raise the droopy side 2 mm at most but it would be all around the arch/in between the brows. Is "evening" brows possible? Where is botox injected to make brows symmetric? Where would I be injected to raise both brows slightly & fix a frown line on one side? I'm worried the typical 25-50 units will be excessive and I will be unable to make facial expressions/close my eyes. #botox #brow lift #locus

Doctor Answers 9

Botox to correct facial asymmetry- a complex mix!

The amount and location of the injections is typically quite complex.  The face exists in a compensated state, with eyelid ptosis, forehead droop, the baseline asymmetries, and the compensating asymmetries all playing a role.

An experienced injector familiar with the anatomy is likely to achieve a nice balance.  Occasionally it requires 'getting to know' a patient's response to the Botox.  There is no set formula.

For example, a patient with eyelid ptosis may appear to have an eyebrow that is too high.  Relaxing that eyebrow may plunge the eyelid down because it was an unrecognized compensated condition that was treated, not the correct underlying condition.

Plastic surgeons comfortable in this area will know the pluses and minuses of brow lifts, ptosis repairs, eyelid lifts, etc. in addition to being able to perform the Botox injections effectively.

They will also know where Botox injections are likely to produce problems, i.e. making eye bags appear worse, limiting anatomic lift of the cheeks, etc.

Beverly Hills Plastic Surgeon
4.9 out of 5 stars 178 reviews

Ptosis and Forehead Asymmetry

Without a photo it is impossible to say correctly how your problem may be addressed.  There are many cases which can be helped with Botox.   Please consult an expert.  Best, Dr. Green

Michele S. Green, MD
New York Dermatologist
5.0 out of 5 stars 78 reviews

Eyebrow/Eyelid Asymmetry -- Botox, Browlift, Fillers

You can use botox to lift the eyebrows but combining with fillers and ultherapy/thermage helps even more.  Please see an expert.  Best, Dr. Emer.

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

Botox for droopy lids and brows

To find the most natural way to correct your issues it would be best to have an in person consult with a board certified plastic surgeon.  They will be able to let you know the exact placement and number of units for botox that will give you the best result and bring greater symmetry to your face.  It is important to know where exactly to place the injections to prevent a droop under the eye or an over arched eyebrow and an experienced injector will understand how to cater to the subtleties of the muscles in your face. Best wishes.

David Alessi, MD
Beverly Hills Facial Plastic Surgeon
4.7 out of 5 stars 16 reviews

Eyebrow lift

Thanks for your question. Botox is a temporary neuroparalytic that is used to eliminate wrinkles in the periorbital and forehead area. Its also works well for softening the 11s (corrugated muscle). Fillers are used to add volume to the face and also deal with dipper folds and lines such as the smile lines and marionette lines. In addition filler can be used for filling the tear trough deformity and adding volume to the cheeks and lips. Please consult with your plastic surgeon to review the best options available for you.
Good Luck.

Ali Sadeghi, MD, FACS
New Orleans Plastic Surgeon
4.9 out of 5 stars 28 reviews

Lifting drooping eyebrows

In order to lift your eyebrows yet eliminate forehead wrinkles, a strategic injection technique is required. You will require approximately 50U of Botox to treat your peri-ocular and forehead region.

Arian Mowlavi, MD, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 68 reviews

I want to raise droopy brows/lids. How much Botox is needed, and where?

The simple answer to all your questions in 2 words is...it depends.  These are legitimate questions and concerns but they only can be answered when a plastic surgeon has a chance to examine and directly assess your face.  How old are you? Why do you have asymmetry? Is botox the best option for you? These are some of the questions I would need to know and figure out if you walked in to my office.  Botox is safe when it is used and done by a board certified surgeon.  Hope this helps and not confuses you more. 
Dr Vasisht

Bhupesh Vasisht, MD
Voorhees Plastic Surgeon
5.0 out of 5 stars 86 reviews

You are in luck!

These issues are simple to fix with a skilled provider.  It is not a "cut and paste" type of treatment.  Because your issues are asymmetric, the injections must also be.  Brow lift can be achieved by placing injections higher than "usual".  To have one side lower than the other, the Botox should be placed farther to the side (lateral) on the side you want lower.  It should be placed closer to the center of your face (medial) on the side that needs to be higher.  In my hands, treating the brow and the 11s ends up being about 34 units and is very natural looking- some of my patients don't even tell their husbands they've had it done!  

Victoria W. Serralta, MD
Arlington Dermatologic Surgeon
5.0 out of 5 stars 1 review

Botox to even the brows

Thank you for asking about your Botox.

  • Botox can definitely alter the brows - 
  • But you need to be examined to know how much Botox, where is likely to work for you.
  • It cannot be calibrated precisely - it depends on how your muscles respond.
  • Always see a Board Certified Plastic Surgeon.
Best wishes - Elizabeth Morgan MD PHD FACS

Elizabeth Morgan, MD, PhD
Atlanta Plastic Surgeon
4.6 out of 5 stars 43 reviews

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.