I Recently Tried Botox for the First Time - Bad Result! Eyelids Pulling Every Time my Eyebrows Move at All? (photo)

Question

Can It Be Fixed? 10 units injected in the forehead, glabella and brows. Forehead smoothed out nicely but eyelids pull with even the slightest movement. Doc told me that I have loose skin over eyes that can only be corrected surgically. Only comments I am getting are "what is wrong with your eyes?" Not the effect I was going for. I am 48.5 years old

Jose Barrera, MD · Answer

Botox for the forehead and glabella can be very effective when injected in the right quantity, location, and concentration. By what you mention, you did the receive the right amount to relax the muscles of the forehead and labella. The location may be an issue as to why you wrinkled afterwards. Also, check with your injector and make sure you are receiving the correct concentration when injected.

Houtan Chaboki, MD · Answer

Botox helps smooth wrinkles around the eyes, such as the forehead. Results are temporary and last about 3 months. When the upper eyelid or eyebrow pull up after Botox, most plastic surgeons will recommend a little more Botox to help relax the muscles. Another option is just to wait until the Botox results go away. Some patients may need plastic surgery to help lift the eyelids or eyebrows, to reduce pulling effect. Speak with your plastic surgeon or dermatologist to review options.

	Dr. Chaboki

Jhonny Salomon, MD · Answer

You can have it repaired with additional Botox injections. You should see your injector and get it corrected.

Steven Wallach, MD · Answer

First, it is importnat to knwo exactly where the botox was injected. The maount of units is pretty low. I fyou have redundant skin in the upper lids, that may require removal. Best to be seen in person to be properly evaluated.

Dara Liotta, MD, FACS · Answer

While its hard to tell 100% what's going on from a few still photographs, my guess would be that you have some residual action of the lateral 1/3 of the eyebrow from the lateral frontalis muscle that was not relaxed with your Botox injection. This can happen when the frontalis is not relaxed properly at its lateral aspect. A very small amount of Botox injected laterally and high (almost to the hairline) should improve your results. While I do agree that would benefit from a blepharoplasty, I also think that your Botox result can be improved with a touch-up.

Robert L. Kraft, MD, FACS · Answer

First, from the limited photo, you do appear to have upper lid redundancy. Next, 10 units of botox is a very small dose when spread among these areas and I would be surprised if it could have produced "eyelid pull". It may be that, while smoothing the forehead, you have become more aware of the eyelids. See a board certified plastic surgeon for a consultation to discuss treatment options.

Toni Stockton, MD, FAAD · Answer

Your forehead muscle ( frontalis) i s pulling the skin upward . A very small amount of Botox injected high in the side of the forehead area in the muscle that is causing this will relax the eye lid pulling.

George Commons, MD (retired) · Answer

10 units in all the areas you mention is an extremely low dose. More typical is 20 u in the forehead and 15 to 20 in the frown. Possibly you are under Botoxed. Botox at any dose takes an adjustment period. You should see the doctor who did your treatment and quite likely the answer is MORE BOTOX. This will have additional cost but may solve your problems. You and the physician injector need to work closely together and after a few sessions you needs will be clear but certainly more than 10 units. While 99% of patients love Botox, I find there is a rare patient who for whatever reason just doesn't seem to be comfortable with the Botox feel. If this is you, you should give up on Botox as a treatment for you. My Best, Dr C

I Recently Tried Botox for the First Time - Bad Result! Eyelids Pulling Every Time my Eyebrows Move at All? (photo)

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