Can I get Botox between my brows if I have congenital ptosis?

I was born with weak levator muscles in my right eye. Was diagnosed with moderate congenital ptosis. I had a levator resection to correct. Now that I'm older I'd like to get Botox for my 11s. Can I get Botox? Will the Botox weaken my already weak eyelid muscles so that they droop again? I've read that eyelid droops can be a side effect.

Doctor Answers 8

Botox for 11's

As long as you go to an experienced injector you should be fine to have botox to your glabellar (between your brows) area. The muscles which are targeted (corrugators, procerus) are not involved with your underlying congenital ptosis. It is possible to have spread of botox which can cause some eyelid ptosis but this is more commonly associated with injections that are done too low above the eyebrows.

Best of luck


Greenbrae Physician

The safety of Botox between your brows (glabella) even in cases of congenital ptosis

Botox is safe to inject between the brows (glabella) in patients with congenital eyelid ptosis.

Although there are a number of causes of congenital ptosis, they all involve structures of the eye.

Botox is safe between the brows, because the target muscles (procerus and corrugator supercilii) do not involve the eyelid/eyebrow.

Forehead muscles (frontalis) can interact with the eyelid/brow position, so those muscle groups should be avoided when using Botox in ptosis patients.

Injection technique is important in all Botox treatments for a safe and happy outcome.

Victor Chung, MD
San Diego Facial Plastic Surgeon
5.0 out of 5 stars 10 reviews

Botox For Glabella Area

You can absolutely have Botox for the glabella area even if you have a congenital condition.  You should consult an expert to have the best cosmetic results. Best, Dr. Green

Can I get Botox between my brows if I have congenital ptosis?

Hello Klocal,

You can certainly receive Botox.  Having had a congenital ptosis should not affect your risk of developing ptosis after Botox.  Using appropriate techniques can decrease the risk of getting an eyelid ptosis to nearly zero, although there is always a risk. You may have a slightly greater risk because of the congenital issue so your muscle starts out weaker.  Even if it did develop, the effects of Botox are only temporary.  

I would certainly mention your ptosis history to your injector and I would recommend you see a physician injector to further decrease your risk of getting ptosis.  

I hope this helps and good luck.  

William Marshall Guy, MD
The Woodlands Facial Plastic Surgeon
5.0 out of 5 stars 25 reviews

Botox between brows with congenital ptosis

Hi Klocal,

Thanks for your questions.  The short answer is yes, you can absolutely get Botox.  When properly placed/injected, Botox should not affect your levator muscle at all, and you will get relaxation of the glabellar (between the brows) muscles only, so that your 11s are significantly improved.  There should be no eyelid droop at all.

I would encourage you to discuss your concerns with a board certified plastic surgeon, ophthalmologist, or dermatologist prior to seeking this treatment, but you should have no issues with an experienced injector.

Best wishes!

Dr. Brown

Daniel Brown, MD, FACS
La Jolla Plastic Surgeon
5.0 out of 5 stars 16 reviews

Botox for 11 in case of congenital ptosis

Hi there,
I do think you can get Botox for the 11s in your case. Having had congenital ptosis and the lavatory resection is certainly something to think about. When you treat with Botox the 11s you are weakening the corrugator muscle which is different from the levator. Small dose and good injection technique is necessary as you don't want the Botox to spread. 
Consider going to an oculoplastic surgeon who also does Botox and aesthetics.
hope this helps! 

Myriam Loyo, MD
Portland Facial Plastic Surgeon
5.0 out of 5 stars 8 reviews

Can I get botox between my brows if I have congenital ptosis?

Thank you for your question. The 11s are caused by contraction of the paired Corrugator muscles at the mid-brow. These muscles lie above the eyebrows, whereas the levators are below.  However, if botox injected at the corrugators gets 'out-of-area' it can impair levator function. Given your history, you may be at
slightly higher risk than the general patient population. I would discuss  this at length with your local provider.
He or She may want to start with a lower-than-normal dosage at the corrugators initially. One of the great things about botox is the ability to add small amounts over time to 'tailor' the treatment effect for each individual patient's needs. Best of luck to you.

Michael F. Bohley, MD
Portland Plastic Surgeon
4.9 out of 5 stars 15 reviews

Botox with congenital ptosis

You can safely get Botox for 11s with congenital ptosis. You need a skilled injector to be sure that it is strategically injected with no spread and be sure you get Botox not a similar product that might be more likely to spread.

Melissa Toyos, MD
Nashville Ophthalmologist
4.8 out of 5 stars 27 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.