I have very pronounced muscles above my eyebrows and an angry resting look- what can I have done to help this?

Question

I am 35 and over the past couple of years the two muscles right above my eyebrows have become very pronounced, you can even see them through my skin. They pull my eyebrows down in to a really angry look. I am desperate to do something about it but I had botox twice with bad results-once with a droopy eye and once with puffiness for months. Are there any other options? Where does botox have to be placed to help this condition? In the hairline or between brows? THANK YOU!

Johnson C. Lee, MD · Answer

Having pronounced muscles over and between your eyebrows are due to the corrugator muscles. The easiest fix is to inject botulinum toxin (Botox, Xeomin, or Dysport) in the appropriate area - within the muscle itself and with enough distance above the rim of the eye to avoid a droopy eye. Another possibility is to manually disable or remove some of the muscle with surgery through a browlift procedure which can be done through incisions in your scalp or your eyelid crease. Have a thorough physical exam by your plastic surgeon to better evaluate the exact cause of your situation. By discussing your goals and your previous treatment attempts, the two of you can come up with a safe and effective treatment plan.

William Portuese, MD · Answer

Botox must be placed directly in the corrugator muscle for it to have any beneficial effect and reduce the scowling ability on a temporary basis. If you have tried and failed Botox , consider a brow lift procedure with surgical softening of those muscles for  a  permanent change. For many the brow lift examples  and more information, please see the video and the link below

Michael Elam, MD (retired) · Answer

Dear holiday81, In patients your age often times an endoscopic brow lift is a great procedure if you are showing signs of aging in the upper third of the face and feel like you look tired. An endoscopic brow lift is often a better choice then botox alone. Botox injected into the corrugator muscles will lessen the appearance of the "11'S" as we call them, however in many occasions surgical intervention is needed to soften the appearance and give a longer lasting result. I have included a link below of a patient your age and a video to show how rewarding and youthful this procedure can be. Best regards, Michael V. Elam, M.D.

I have very pronounced muscles above my eyebrows and an angry resting look- what can I have done to help this?

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Everything you need to know about Brow Lift

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I have very pronounced muscles above my eyebrows and an angry resting look- what can I have done to help this?

Answers (3)

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Recommended reading

Everything you need to know about Brow Lift

Our mission is to create a world where every investment in modern beauty is Worth It.