1-week post-op: severe droop in the middle of my brows and what looks like "bruised eyes" after Dysport what do I do? (Photos)

I'm sorry to hear about your situation. You don't look that bad. To raise the eyebrows, adding more Dysport below the brows is the way to go. This should create a chemical brow lift effect. Because the forehead muscles are relaxed the "lift" won't be huge, but it might help. You have heavy eyebrows and, in the future, Dysport should only be used in the high forehead or not at all.Good luck, Dr. ALDO 

Sorry to hear you treatment didn't achieve your goals.  The injections in your forehead have weakened muscles that elevate your brow.  It may take some time for the dysport to start to wear off, and as it does your brows will slowly re elevate.  To improve the situation additional dysport can be placed in the lateral brow into the orbicularis to weaken the muscles that depress the brow.  This can help elevate the lateral brow.  The medial brow is usually elevated by injecting the corrugators, but that likely has already been done to treat your frown lines.  Note that dsyport is used to relax muscles, so it addresses dynamic lines in the skin.  If you have a deep crease in the skin when you are at rest, as your image suggests (11's), then you may require some filler.  

Hi Kate,
If neurotoxin (botox/dysport) is injected low on the forehead, it can cause the eyebrows to drop (the forehead muscle is the ONLY eyebrow elevator). 45 units of dysport to the forehead is standard. The frown muscles (corrugators, procerus) pull the middle of the eyebrows down and in - paralyzing them can help relax the medial part of the eyebrow. 20 units of dysport is a low amount in this area and more here may help you. A careful follow up exam may help determine if you will have a benefit from more dysport.
Good luck,
Mehdi Sina, MD

I'm sorry to hear about your frustrations. A fallen brow can be caused by too much product, placing the injections too low on the forehead or a combination of both. Sometimes adding a bit more Dysport just below the brows can make the brow look less heavy. As for your frown lines, your injector may need to increase the volume of product used in that area. Be sure you follow up with your injector so your next appointment can be customized to avoid these concerns in the future. Best of luck.

I am sorry you have had this experience with Dysport.  I have several suggestions.  First, an experienced physician can inject Dysport right under the eyebrows, which relaxes the muscles that pull the brows down.  Sometimes, when the forehead becomes too relaxed, the muscles under the brows are the only ones working and "go to town", pulling the brows down.  A small amount of Dysport will relax them, allowing the brows to pop back up.  Secondly, 20 units of Dysport into the frown lines between the brows is a very small amount, so I'm not surprised that it is not helping those lines.  I generally begin with 50 in that area.  I do tell patients who have lines there at rest (like you do), that Dysport will soften and improve those lines, but the lines won't completely go away until you do Dysport 3-4 times in a row (meaning every 4 months or so).  In the future, you should always let your injector know that you have experienced heavy brows, so that they use a conservative amount in your forehead and stay in the upper half of the forehead.Best of luck to you.

Thank you for your question and submitting your photos. Dysport is a neuromodulator that blocks communication between the nerve and its muscle. The frontalis is the muscle that is treated to reduce lines on the forehead. This is the muscle that normally raises the eyebrows. When this muscle is weakened there can be a heaviness to the eyebrows, especially if the neuromodulator is placed lower. This heaviness should resolve as the Dysport effect wanes in the coming weeks and months. Sometimes a lateral brow lift will diminish the effect of this heaviness. You should speak to your physician about your results so that they can develop a future treatment plan should you decide to have a neuromodulator again in the future.I hope this was helpful - Dr. Moore.

Sounds like the forehead injections were placed very low in your forehead. In order to remedy this condition, in addition to wait, corrugator muscles ( opposing groups) as well as orbicularis muscles need to be injected.

When Dysport is injected between the eyebrows, if the injection hit the forehead muscle, it will paralyze that muscle and consequently would drop the center part of the brows.  There is not much that can be done to counter that effect.  It will take about 4 months to wear off.  Injections need to be more inferiourly placed to affect the suppressor muscles allowing the brows to raise centrally

Thank you for your question.
The effect that you are describing basically occurs when a dose of Botox that is too high is injected in the same vertical plain of the temporalis muscle to cause droopy eyelids.
Unfortunately there is no additional treatment to offer that would expedite the effects of your Dysport treatment. The effects are temporary and you should see increasing improvement of the effects over the next few months.
I suggest that you review the results with your injecting practitioner. Please consult with an experienced and highly trained practitioner to ensure your safety and for optimal results to be achieved.
Best wishes.

Good day. Thank you for your question, photographs and narrative.Analysis of your photographs reveals several issues: 1. Brow ptosis or drooping medial worse than lateral. 2. excess skin to the upper eyelid 3. volume loss to the lower eyelid area known as the tear trough 4. persistent midline forehead wrinkles and vertical glabellar wrinkles.When the brow is positioned lower than optimal before the muscle relaxant injection and with excess skin to the upper eyelid, this patient is at risk to producing brow drooping (ptosis) and more pronounced upper eyelid skin appearance. In this patient, a conversation with the patient to discuss the risks, limitations of the degree of animation wrinkle improvement without producing the brow ptosis complication, and benefits of the injections to the glabellar area, crows feet and forehead that can be attained.Injecting a filler along the superior brow hair to produce a brow lift or to perform a brow lift surgery, undergoing an upper eyelid cosmetic surgery (blepharoplasty) to excise the excess skin, both would lower the risk of brow ptosis in the future. In patients not desiring upper eyelid surgery or brow lifting, then less Dysport/Botox needs to be injected to avoid complications. The patient needs to accept the residual wrinkles after the injection. If brow drooping occurs fro the Dysport/Botox injection, one needs to wait for the natural metabolism of the medication since there is no other treatment t increase the neuromodulator metabolism. Initial injection with a 14 days followup is essential to document complications and establish a satisfied patient related to improved animation wrinkle appearance. Best of luck.