What do I do about slightly drooping brow arch after Botox?

Question

I had forehead botox done yesterday and noticed that I have less of an arch in my eyebrows than I did before. They look straighter & lower than before. Will this correct itself in a few days or would I need a separate procedure to correct this? It's nothing drastic, but I tend to subconsciously hold my eyebrows up while talking, and posing for pictures, etc and now just the inside of my brows (closer to my nose) go up, giving me a bit of a "worried" look. Any thoughts? Thanks in advance.

Nelson Castillo, MD · Answer

Thank you for your questions.  Botox's effects typically will take between 7-10 days to reach maximum effect. In the meantime, there can often be subtle alterations to your appearance that can autocorrect themselves.  I would allow a couple of weeks to pass and then assess your results.  If your brow continues to be dropped, touch ups to the area between your eyes, lateral eyebrow, and crows feet can be done to try and improve your result.  Hang in there!

J. Kevin Duplechain, MD, FACS · Answer

Its a little early to tell if you are going to have a problem.   Botox typically doesn't have much of an effect for 72 hours and I tell patients to wait 7-10 days before anything final opinions are rendered regarding treatment.

Michael Boggess, MD · Answer

Hello.  The position of the brow is determined by the relative tone in the muscle that elevates the brow (frontalis) and the muscles that lower the brow (procerus, corrugator, orbicularis).  Botox acts to weaken the muscles into which it is injected.  If only the brow elevator (frontalis) is injected, this can result in lowering the brow.  Often, the brow depressors are also injected at the same time to treat frown lines and crow's feet, which results in weakening of the brow depressors, which should counteract any brow depression resulting from injecting the frontalis.  The result that you can expect will really depend upon which muscles your provider injected.  It usually takes 3-5 days, and possibly up to a week, to see the full effects of the treatment.  So it is a little bit early to be concerned about the result.  I would suggest waiting 2 weeks and if the drooping of the brow persists, your provider may consider injecting the orbicularis muscle just below the outer aspect of the brow to provide some lift to the brow and restore a natural arch.  I hope this information is helpful.

Martin Jugenburg, MD · Answer

Thank you for your question. It does take a full 2 weeks for the Botox to settle. Allow this amount of time before any corrections take place. If at 2 weeks you still have a low arch speak with your injector and perhaps a Botox brow lift will help. Have a wonderful day,

Reza Momeni, MD, FACS · Answer

Most of the time, this drooping gets better by 3 weeks in my experience.  If it doesn't there are medications to help the eyelids raise up a bit.  For the forehead, there's not antidote to Botox, so tincture of time will take care of it in my experience.  I've never seen this to become permanent.

Steven Wallach, MD · Answer

Sometimes if the botox is placed very low, it can cause the brow to droop a bit or flatten the arched brow. Usually this is a technical issue. Best of luck.

Gordon Searles, MD · Answer

Many people may not be aware that they unconsciously use their forehead to lift the eyebrows and sometimes their eyelids.  With the relaxation of the forehead muscles, you have temporarily lost this ability, leading to a slight downward drift of your eyebrows.  The upward lift in the middle suggests that this portion of the forehead is still more active.I agree that it may be too soon to say if this effect will last.  Ten to 14 days would be a good timeline to see.  If it still is an issue by then, a good injector will be able to retouch and restore the balance and look that you want.  Moving forward, this would be a good thing to remember to tell your injector the next time you have the procedure.  By knowing this can occur with you, your injector will be able to make adjustments so as to avoid this issue in the future.

Steven F. Weiner, MD · Answer

It is still too early to be concerned. Wait about 2 weeks to see end result. A good injector is able to touch up many issues at that time. A common error is injecting too much or too low in forehead causing eyebrow problems.

Gustavo A. Diaz, MD · Answer

I would recommend to wait at least 2 weeks from the injections. If you still have the loss of the arch at that point, then consider injections also the glabella and crows feet area in order to elevate the brow.Hope this helps,Dr. Gus DiazDouble Board Certifies in Facial Plastic Surgery

What do I do about slightly drooping brow arch after Botox?

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