Extra folds in eyebrow/eyelid after botox? (Photo)

I had 24 units of botox for the first time 5 days ago (forehead/crow's feet). The forehead feels very heavy and there are now extra 'folds' in the creases of the lid. Can this be fixed with more botox or should I wait 3-4 months? Does the heaviness go away?

Doctor Answers 8

Extra folds in eyebrow/eyelid after botox?

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Hello, and thanks for your question and photo. I'm sorry you did not get the result you had hoped for. What happened is that due to the dosing and technique used, your brow has dropped, resulting in the lines you are seeing. The good news is that this should slowly but steadily improve over the next few months. In order to determine the best treatment plan for you, I recommend an in-person consultation with an expert. Best of luck, Dr. Frucht.   

Santa Barbara Dermatologic Surgeon
5.0 out of 5 stars 4 reviews

Botox and eyelid folds

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The botox may have caused the brow to descend leading to the eyelids having extra creases.  Best to allow it to wear off in 3-4 months.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Lid folds after Botox

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Botox didn't cause the lid folds, you had them prior to the Botox. The problem is that you were raising your eyebrows slightly and this was preventing you from seeing the excess skin in the upper lids. After Botox, you couldn't raise your brows and the excess skin is now visible. Glabellar Botox can relax the muscles that pull the brows inward / downward, but I'd be surprised if it helps lift the brows or makes the lids look better. If you have very little to no motion in the forehead right now, I'd recommend letting the Botox wear off and getting a lower dose higher in the forehead in the future to prevent complete lack of motion. You could also consider an upper blepharoplasty (easy to perform in the office) to get rid of the excess skin in the upper lids.

Andrew Campbell, M.D.

Facial Rejuvenation Specialist

Quintessa Aesthetic Centers

Andrew Campbell, MD
Milwaukee Facial Plastic Surgeon
4.7 out of 5 stars 25 reviews

Heavy forehead after Botox

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Thank you for your question Virgo1984. I am sorry to hear about your situation. Botox is a purified protein used to address wrinkles associated with facial expressions. Most people see the results of their Botox treatment in 3-7 day, but it could take up to 2 weeks to see full results. In our office we have patients return at that time to take after photographs and assess the results. It is difficult to assess results without a before picture. If Botox was placed improperly in the forehead (too much or too low) a heavy brow can be seen. This goes away in 3-4 months. Placement of Botox in the muscle that pull down the brow may help. Please consult with a doctor for specific recommendations. Good luck!

Botox results

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You mention having the forehead and crows feet done, but what about the glabella region ( the muscle complex in between the brows)? This group functions to pull down and inward. If the forehead muscles are relaxed and the glabella is not treated it can 'take over'. Additional units of Botox in the Glabellar group and in the depressor supercilli muscles can alleviate this appearance.


Lisa Vuich, MD

Lisa Vuich, MD
Nashua Physician
4.7 out of 5 stars 11 reviews

Eyebrow-eyelid complex

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Lowering of the eyebrows following relaxation of the frontalis muscle could be improved with additional injections on the eyebrow depressor muscles. In your pictures the eyebrows are not particularly low set and the skin folds are also due to volume loss in the eyebrow-eyelid complex. Hyaluronic acid gel filler injections can replenish the volume loss,  improve the 3D contours and ameliorate the folds. 

Costas Papageorgiou, MD, FACS
London Oculoplastic Surgeon

Brow ptosis

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Botox takes a full two weeks to kick in.  It is best to return to your provider and get an assessment at that time.  The forehead muscle is your brow elevator so too much botox or improper placement in this area can lead to brow droop.

Martin Jugenburg, MD
Toronto Plastic Surgeon
4.9 out of 5 stars 517 reviews


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It typically takes 7-10 days to see the full effects of Botox. Depending upon the areas that you had treated, especially if you had the entire forehead treated, there can be some heaviness of the eyebrows.  If you are still concerned with the way you look after the 10 day period, I would make an appointment to speak with the doctor who performed the injection.

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.