Is Botox to lift my eyebrows not working anymore? (Photo)

am almost 46 years old, oily skin and I am not overweight. I would like to ask the doctors: I've been doing Botox since I was 40 years old but I noticed is not working anymore to lift my eyebrows. Is it time to consider a forehand lift or eyes surgery ( excess of skin?)

Doctor Answers 9

When Botox brow lifts no longer work

When Botox brow lifts no longer seem to work there could be several reasons:

1. Did you go to a different injector who might have injected differently or with less units?

2. Your skin laxity may be overcoming what Botox can do to lift your brow.

3. You may be losing volume (fat) under your brow which may be worsening your brow droop and making it harder for Botox to lift it.

Sometimes increasing the dose can help or putting filler under the eyebrow.  Where I practice in Orange County Botox and fillers are often used together to help this problem.  Good luck.


Laguna Niguel Dermatologic Surgeon
4.9 out of 5 stars 211 reviews

Consult a board-certified PS about surgical and non-surgical options

It is possible that BOTOX® can't address the way your eyelids and brow are changing. While BOTOX® may continue to be a good way to smooth the vertical lines between your eyebrows, you may benefit from a different type of rejuvenation to lift the sagginess of your upper eyelids. It's possible a non-surgical treatment like Ultherapy will be effective. Or you may be a good candidate for upper eyelid surgery. I recommend meeting with a board-certified plastic surgeon to discuss your options. Best of luck!

Adam L. Basner, MD
Baltimore Plastic Surgeon
4.8 out of 5 stars 36 reviews

Botox to lift brows

Thank you for your question.

After time as we age the botox may not give us the desired result it once did. The botox may be lifting your brow, but it appears you have some excess skin on your upper lids that is still there. It is hard to determine without seeing you in person what you would need exactly. You may benefit from a temporal brow lift and upper lid blepharoplasty. I would suggest contacting a PS in your area for an in person evaluation. Good luck.

Francis Johns, MD
Greensburg Plastic Surgeon
4.8 out of 5 stars 60 reviews

Botox not giving me the eye lift it used to

The "chemical brow lift" with Botox is good for 1-2mm of lift. More than that, surgery is needed. It might be an upper bleph or a brow lift. This would be up to the surgeons discretion. Filler in the brow and temple area will often give a lift as well.

Steven F. Weiner, MD
Panama City Facial Plastic Surgeon
4.6 out of 5 stars 27 reviews

Botox and Results / What Age To Start? / When Wear Off For Lifting the Eyebrow?

you likely are aging and have heavier lids that need surgical removal or a combination of skin tightening/lifting such as ultherapy or thermage with exilis/venus legacy to this area long term.  Fillers to the brow, forehead also help.  Best, Dr. Emer.

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.9 out of 5 stars 166 reviews

Botox Brow Lift No Longer Working

Hi and thanks for your question. The brow lift that we get from Botox mostly happens because we weaken the muscles around the eyes. Sometimes you have to adjust the dose of the Botox with age and sometimes you have to add a filler like Voluma to replace the lost volume of the bony brow. Sometimes you have to adjust the dose of Botox to other areas of your face that affect the brows such as the forehead. From your pictures those approaches may yet work, but if not, then surgical options may at this point be your best bet. I would suggest getting the opinion of an experienced injector to decide on which direction to go. Hope that helps.

Is Botox to lift my eyebrows not working anymore?

From your photo it appears so. 1) The problem may lie with the Botox. It may have been a bad batch or you may have developed antibodies that now block the Botox from working. These are rare occurrences but I've done enough injections to have seen both. 2) The Botox is working but, because of the thinning of brow and loss of skin tone that occurs with time, Botox is no longer sufficient to give the desired result. The good news is that you appear to be a good candidate for an excellent result. Due to your high hairline I suggest you consider an Irregular Trichophytic Hairline approach. Good Luck.

Curtis Perry, MD
Downey Facial Plastic Surgeon
4.8 out of 5 stars 16 reviews

Botox results and eyelid surgery

In the appropriate patient, Botox can be used to raise the eyebrows and open up the eyes. When this stops working, a filler can be added to help revolumize the brows and possibly provide support to the upper lid. Energy based device such as Thermage or Ultherapy can also help raise the brow. Honestly though, a patient with significant skin laxity involving the upper eye lid is usually best treated with blepharoplasty (eyelid surgery).

Botox brow lifts

Botox and other neuromodulators can be used to create some lifting of the lateral brow in some patients.  However, as we age an lose volume of the bony part of the brow and get more laxity, these treatments are less effective or can create a weird appearance.  Non-invasively, fillers can be used in the brow and temple to support the upper lid.  In combination with tightening treatments, this can create a nice result.  Surgically, you may be a candidate for a brow lift combined with an upper blepharoplasty.  Either way, make sure to seek out an expert in facial injectables or surgical approaches.  Fully discuss your desired results and have an open conversation of the risks and benefits of either procedure prior to having it performed.

Kyle Coleman, MD
New Orleans Dermatologic Surgeon
5.0 out of 5 stars 7 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.