One eyebrow higher than the other after touch up?

Question

I had my initial botox done over 2 weeks ago and had to go back for a touch up as forehead still had lines and wrinkles abouve both eyebrows when raising them, after the touch up forehead and one brow was perfect, however right eyebrow was now higher than other one. Went back for another touch up 5 days after first touch up and she placed one more injection above that brow. Now 48 hours later it's still the same? I've had Botox before and never usually had to go back for even one touch up.

Jason Emer, MD · Answer

It will take 1-2 weeks for final results after your last touch-up. Botox results last 3-4 months. If you're unhappy with your final results, venus legacy and thermage treatments can help soften results. See an expert. Best, Dr. Emer

Nelson Castillo, MD · Answer

Thank you for sharing your question and I am sorry that your current results have not been what you anticipated.  In most cases it was advised to place a small amount of Botox into the area above your eyebrow to help lower it but remember that it typically takes 3-5 days for Botox to start working and this most recent treatment has probably not taken effect.  If after 12 additional days you have similar outcomes seek a second opinion for treatment.

Wayne Wertheim, MD · Answer

you need to give it time. but it seems your injector is doing the right thing just being conservative. Since this is new for you that is a good approach for the injector to take. With each correction the injector is learning your unique needs based on your muscles and should be making notes so that in the future they can adjust the treatment so only one treatment is necessary.

Alex Eshaghian, MD, PhD · Answer

Thank you for your question kat195. 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 without
more information such as the dose used and where the product was placed. However I hope the information here is helpful.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.There have not been such studies published for
the horizontal lines on the upper forehead. However, in my experience I find
that 10-20 units works well in this area. For patients with narrow foreheads a
lower dose may be used and those with a broad forehead generally require higher
doses. I have also found that the full results in this area are seen by two weeks.
Therefore, we have our patients return two weeks after their treatment to
assess the results via photographs. At that point additional units may be used
if further enhancement is desired.When correction, additional units, or touch ups are performed, it is important to wait a full two weeks after the last treatment before assessing the results as it could take this long for the full effects from the previous treatment to be seen. Patience is important.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.When Botox is used in the upper forehead, if the
dose is too high or the placement is too low it can result in the feeling of
heaviness in the eyebrow or even lower the position of the brow. In order to
reduce the risk of this possibility, I use a conservative dose in the area and
place the product high on the forehead, sometimes near the hair line. Additionally,
I recommend that my patients simultaneously receive a small amount Botox
between the brows and at the corners of the brows. This will relax the muscles
that pull down on the brows to counteract this effect and provide a harmonious
balance to the position of the brow. The results are assessed two weeks after
the treatment. If there is any asymmetry a small amount of Botox can be placed
in the upper face for correction.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 as described above. 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!

Martie Gidon, MD, FRCPC, FAAD · Answer

It takes about 12 days to see the full effect of your Botox treatment.  Wait another 10 days and if your forehead lines are still not symmetrical, please visit your doctor again.

Shaun Patel, MD · Answer

Sorry to hear about your experience. As others have mentioned, I would give the Botox 14 days to take full effect. If at that point you still remain unhappy with your results, I would consider a second opinion with another, possibly more experienced injector. Good luck.

Melvin Elson, MD · Answer

48 hours is not enough to determine the effects of the botox and actually neither was the 5 days when you had another injection.  wait a total of 2 weeks and see what it looks like at that point. Be sure you see a board certified dermatologist

Paul C. Dillon, MD · Answer

This cannot be addressed without pictures.  I would resubmit your question with pictures.  The causes and the solution vary depending upon how much of a difference exists between the left and the right.

One eyebrow higher than the other after touch up?

Answers (8)

More Botox Questions

WE SEND PRETTY
EMAILS

Answers (8)

More Botox Questions

25, undereye wrinkles, crows feet when smiling. What treatment would be best? If its botox, how many units would I need? (photo)

Roaccutane thins the skin. Is it safe to have Botox and dermal fillers whilst taking roaccutane for a long time?

Is Botox in the jaw muscle a good alternative to surgery?

Any surgeries to fix uneven trapezius muscles? (Photo)

Can clinical strength anti perspirant such as Driclor kill sweat glands? As that has seemed to happen to me

WE SEND PRETTY EMAILS

WE SEND PRETTY
EMAILS