Botox has created new crease in the body of my brow. (photo)

I had botox injection for crow lines, frown mines and on the forehead . i have had botox injections by the same md for the past 3 years. i now get unusual looking creases/lines in just one of my brows if i unintentionally frown or make any sort of facial expression. i went back to the md after 3 weeks and he said nothing can be done about it without my eyelid drooping. i have naturally high arch so always insist not to have them raised. please tell me what caused this?

Doctor Answers 10

Wrinkles after Botox

Thank you for your question leylagoldie. Botox is a purified protein used to treat certain wrinkles on the face associated with facial expression. The most common area of treatment is the glabella, or the area between the brows where we see vertical lines when we frown. This area is a complex of multiple muscles including the procerus which pulls the center of the brow down and the corrugators which pull the brows inward. I individualize treatments for each patient so that the injection treats the muscle bulges. For example some people have a stronger procerus and in these cases I use more units in the central part of the glabellar complex. Others have more prominent corrugators and in these cases I use more units in the outer parts of the complex.
Sometimes there are areas of the outer portion of the corrugators which are not treated. This can be easily corrected with 2-4 units in the area. Care must be taken so that the injection is not place on the bone and not too close to the eye, as this may lead to droopy eyelids, a rare but temporary and treatable side effect of treatment in this area. I recommend speaking with a doctor for specific recommendations. Good luck!

Encino Physician
5.0 out of 5 stars 1 review

Botox and new creases

Some additionally units of Botox very carefully and judiciously placed can alleviate this wrinkling - it may take one or two injections, but it is best to inject smaller quantities and add to the titrated effect so as to not drop the brow.  Botox is an art and every unit counts!

T.G. Khan, DO, FACS
Fort Lee Oculoplastic Surgeon
4.5 out of 5 stars 24 reviews

Botox - how to get rid of the unusual lines

Thank you for your question about your Botox.

  • The effect is from the corrugator muscles.
  • I cannot tell from the photo if this can be treated or not.
  • I suggest you see a specialist for a second opinoin -
  • Always see a Board Certified Plastic Surgeon.

Best wishes. Elizabeth Morgan MD PHD FACS

Botox and New Crease

Botox is an art and it seems from your photos that you can have this corrected by having a small amount in your forehead to compensate for this wrinkle.  Please consult an expert in Botox.  Best, Dr. Green

New muscle after Botox

Over a period of time it is not unusual for the muscles that have been injected to become weak and a muscle in the vicinity tries to take over (called recruitment). this muscle can be treated but the doctor will need to inject high in the muscle away from the eyebrows to soften the appearance

Melvin Elson, MD
Nashville Dermatologist
5.0 out of 5 stars 6 reviews

New Creases From Botox?

Looks like you may need a few more units of Botox in the left brow area. Some of your muscles are still active in the area, giving the appearance of the creases. Botox in that left corrugator muscle shouldn't raise the brow.

Millicent Odunze-Geers, MD, MPH
Sacramento Physician
4.6 out of 5 stars 5 reviews

Botox has created new crease in the body of my brow

Thank you for your question.  Based on your photograph it appears that much of the musculature of your forehead has responded well to the Botox administration but not the left corrugator.  The corrugator is found between the eyes and is responsible for creating the vertical wrinkles seen in your picture.  Additional Botox placed into the belly of this muscle should resolve these wrinkles at little risk to dropping your eyelid. Hope this helps.  

Nelson Castillo, MD
Atlanta Plastic Surgeon
5.0 out of 5 stars 38 reviews

Botox and movement

Botox injected in the forehead may cause the other muscles to compensate for the inaction of the treated muscles. It looks like your lateral corrugator may be compensating. Sometimes a small amount in this  muscle improves the appearance.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 24 reviews

Botox and residual corrugator muscle activity

I suspect the creases are from residual activity of the corrugator muscle which is part of the glabellar (frown) muscle complex. What likely happened is that the injector injected the medial part of the muscle but not the lateral part resulting in residual activity in that part of the muscle. This can be fixed by injecting a small amount of Botox laterally 1-2 cm above the brow.

Botox for glabella muscle complex

A few units of Botox placed into the corrugated muscle on the left should soften this without dropping your browser
Lisa Vuich, MD

Lisa Vuich, MD
Nashua Physician
4.7 out of 5 stars 9 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.