is it normal for botox to look different when I first wake up?

When I look in the mirror washing my face first thing in the morning, my botox is way more active on one brow/eyelid than the other. One eyelid is baggy and the brow lower than on the other side. Later in the day it seems to even out. Does botox migrate within a small area like that--or is something wrong? Have you ever seen this? Thanks for any insight you can provide! -Natalie

Doctor Answers 6

Botox and uneven appearance

Botox is a fabulous injection to remove facial wrinkles and it is no surprise that it the number one most popular injection now in the US.  However, the irregularities that you are describing should be addressed.  Please consult a board certified dermatologist with a great deal of experience with cosmetics and Botox injections for the best results.

New York Dermatologist
5.0 out of 5 stars 78 reviews

Return to Provider with Concerns about Botox Migration

Botox is a great product as we all know, and those of us who have been injecting this for a long time are thrilled with how patients respond and how safe it is — most every time. Please make sure you are going to a skilled injector — a board-certified dermatologist or plastic surgeon should be the ones injecting Botox or someone under their supervision with the skills needed to make you look your best.Anytime anyone is unsure if their results are going correctly, they should call their injector and get into to see them to compare pictures and have an examination to see if you are experiencing any eyelid or brow drooping — we call this ptosis — and although rare in today’s world and with more and more unexperienced injectors, you need to make sure you are not having this. And if so, prescription eye drops may be used to minimize it for you.Botox takes effect within 2-3 days, its effects are usually set within 1-2 weeks and then the results should last for 4-6 months in most everyone. But if you have any concerns, return to your provider.

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

Botox takes up to 2 weeks to see the full effects.

Botox takes up to 2 weeks to see the full effects. Over the 2 weeks you will see changes taking place. If you have any concerns follow up with your injector to discuss concerns.


Martin Jugenburg, MD
Toronto Plastic Surgeon
4.9 out of 5 stars 469 reviews

Botox More Active on One Side?

Hi Natalie.  It depends when the Botox was placed.  If it has been a week or two since you had the injections then the product should have full effect.  If it was recently placed within a day or two, there may be more time before the injections have settled completely.  After a week or two, if the eyelids still look uneven, then you may have a bit of ptosis (eyebrow or eyelid droop).  Your injector may be able to help by performing a "Botox browlift" to lift the side that is heavier and lower.  

Good luck and for examples of before and after photos of Botox injections in Los Angeles, click the link below.

Harold J. Kaplan, MD
Los Angeles Facial Plastic Surgeon
4.4 out of 5 stars 7 reviews

Botox appearance

It is common to have an asymmetrical appearance during the first two post treatment as botox needs to fully activate. However, after this time, botox should appear the same throughout the day. Consult with your injector as he or she knows the specifics of the treatment and about you.

Kris M. Reddy, MD, FACS
West Palm Beach Plastic Surgeon
4.5 out of 5 stars 42 reviews

Botox and Eye Movement

It is typical for things to look asymmetrical the first 14 days after injection as the botox is working in some areas and taking time to work in others.  Give it two weeks and if not better consider seeing your physician for evaluation.  Best, Dr. Emer.

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