Botox caused deep wrinkle to appear above eyebrow after about a week. Will it ever go away? (Photo)

Question

I have had botox treatments for years with no problems. The last time, 2/6/19, a deep crease appeared above my right eyebrow, even when I am not moving that muscle. The provider tried to touch it up on 2/22/19 but to no good effect. The crease has been there for several months now, and I fear that, at my age with less than elastic skin, it will become permanent.

Ron Shelton, MD · Answer

I have seen this crease form after I have conservatively treated just the area between the eyebrows (glabella) to reduce the "11" and help lift and open up the eyes. If one were to inject this crease with Botox so close to the eyebrow, it will lower the eyebrow. The explanation for this temporary crease, which disappears as the Botox wears off, is not well understood, but is easily treated with a superficial filler, such as Belotero or Juvederm Ultra, injected immediately beneath this line. Speak to your physician about its risks.The information provided in Dr. Shelton's answer is for educational purposes only and is not intended to constitute medical advice.  The information provided should not be relied upon as a substitute for consultations with a qualified health professional who may be familiar with your individual medical needs.

Elham Jafari, MD · Answer

Hi and thank you for your question! It is very important that you do an objective  comparison with pictures taken before the last Botox treatment to be able to accurately determine what has happened. If the crease is caused or worsened after Botox, it is expected to go back to where it was after a few months and as Botox wears off normally. If the issue persists, you can consider other treatments such as Ultherapy to help tighten and lift the skin. I hope it helps and good luck!

Nelson Castillo, MD · Answer

Thank you for sharing your question and photograph.  If due to your Botox treatment, this wrinkle should disappear once the Botox wears off in the 3-4 month mark, or whatever your typical duration level is.  I would recommend examining your before and after photographs to ensure resolution.

Camille Cash, MD · Answer

The wrinkle you are seeing is likely from the surrounding area being smoothed by the Botox.  It should gradually return to normal as the effects of the Botox wear off.  Typically this takes 3 to 4 months.

Mark Kearns, MBChB, BSc, FRACGP · Answer

Hey there thanks for the question! It does look like a little bit more botox placed above the brow there would help to even out that crease, but it might well drop your brow somewhat which would be the trade off. I'm sure your injector would be able to help maying this decision - hope that helps.

Vibha Gambhir, MD · Answer

Hello and thank you for your question.  Definitely review photos taken prior to your botox treatment.  Either way it is not unusual for lines above brows to appear deep or deeper after botox in surrounding areas.  It is a very tricky area above the brow, if treated incorrectly, your brow will drop.  We have done tiny doses of botox high above brow to help soften the lines.  Some clients chose not to treat lines for fear of dropping brows.  If you do not want to risk brow drop or heaviness from botox, a thin filler can help (volbella).   Botox typically lasts 3-4 months, this line should soften a great deal after botox has worn off.  Make sure your provider is experienced in botox above brow and is an expert injector. I hope this helps, good luck to you!

Narin (Joe) Apisarnthanarax, MD · Answer

When you see a crease after Botox, its usually one of two causes:1.  The line was already there but became more apparent once Botox smoothed out the surrounding skin.  You can look at a photograph before the treatment to see if the line was present before.  If such a line is present at rest, then you may need fillers to lighten it up.2.  There is activity in a muscle that was not blocked by the Botox.  In this case, if the central forehead is blocked, but there is residual activity above the eyebrow, then your lateral brows may be a little bit more elevated, causing the line to show.  This is typically easily corrected with a little Botox over the lateral forehead, although there is always a chance your brow may feel a little heavier.

Katrinka L. Heher, MD · Answer

This line right above your brow is caused by your forehead lifting the brow.  If Botox is placed to improve this it will definitely lead to a lowering of your brow which is a less desirable result.  Thankfully Botox is temporary so all should return to baseline in a few months. Wishing you the best of luck!

Anteneh Roba, MD · Answer

Effects of Botox usually last three to four months. Occasionally in some people it lasts longer but it’s effect is never permanent.

Botox caused deep wrinkle to appear above eyebrow after about a week. Will it ever go away? (Photo)

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