Overly arched brow from Botox from 6 days ago.

Question

Botox 6 days ago, upper forehead, crows feet & brow lift. Maybe 30 un. total. I'm concerned about brows. At rest they aren't bad (higher than I would like, weird arch but not too obvious) but when I DO raise them they arch like the Joker. Looks bad. Been doing Botox for a few years & this has never happened before! I know I should wait 2 weeks & maybe it'll even out but what's better? Waiting & avoiding brow raising? Or getting corrective botox? I don't want to freeze my forehead. Thanks.

Stephen Prendiville, MD · Answer

First I will caution you that it takes 2 weeks to see the final result from Botox.  However, your description of dosing is suggestive of under-treatment based on Allergan therapeutic doses.  A patient requesting  brow, crows feet and lateral brow elevation would typically receive about 50 units in my hands.  The odd arching you are describing is known as a "Mephisto" line related to inadequate treatment of the lower lateral frontalis muscle.  This is very fixable with more Botox. In my opinion, it is always better to have a complete treatment than a half-baked result and a confused patient.

Martin Jugenburg, MD · Answer

From what you are explaining it sounds like this could be corrected easily with a few units of botox in the lateral areas to relax the strong pull.   I would wait another week as sometimes it takes a full two weeks for the botox to fully kick in .     Good luck !

Christopher J. Davidson, MD, FACS · Answer

Thank you for your question.  An over-arched brow can easily be fixed with an additional few units to the frontalis muscle (forehead).  My advice is to follow-up in one week for evaluation and adjustment.  Best of luck.

Michael P. Morrissette, DDS, FACS · Answer

easy fix... don't wait for it to improve... return to your injector for a little more botox "touch-up".

Kenneth D. Steinsapir, MD · Answer

Your forehead is unnecessarily paralyzed.  The pattern is causing recruitment of the lateral frontalis muscle, which is probably the only thing still working.  It is possible to impose a correcting treatment using the Microdroplet Lift® at the eyebrows but this should wait until some of the treatment you have just had begins to where off.  That will be in about 4 to 6 weeks.  Without a correcting service, this forehead appearance will persist for several months.

Jason Emer, MD · Answer

Yes, Botox results take 1-2 weeks. Botox results last up to 3-4 months and can be softened with venus legacy and thermage treatments. I recommend getting a formal evaluation with a cosmetic dermatologist. Best, Dr. Emer

Daniel Barrett, MD · Answer

Dear SallyAnne,Botox is generally an on off switch for muscle activity. I get a fair amount of actors/actresses in my practice that are looking to reduce wrinkles but keep some expression. Most of patients see first changes after 4-7 days and the final results after 10-14 days. I would suggest you to wait to see the final results.Daniel Barrett, MD, MHA, MS 
Certified, American Board of Plastic Surgery  
Member, Am. Society of Plastic Surgery

George Ibrahim, MD · Answer

This can happen, and is the easiest problem to fix.  Just go back and let your injector add a tad above the arch.

Esta Kronberg, MD · Answer

This over arched brow can happen. It is easy to fix and just takes a few units. Be sure to go to an experienced injector.It won't affect your forehead.

Peterson Pierre, MD · Answer

It sounds as though the "joker" look bothers you so I wouldn't wait till it wears off in 3-4 months. Corrective Botox is the way to go! It will require a small amount which shouldn't freeze your forehead but will restore your confidence and help you look your best.As with all cosmetic treatments, the skill of the doctor is of utmost importance. Don't trust your face to just anyone! Consult with an expert in facial aesthetics to maximize your results while minimizing side effects. You'll be happier and save money in the long run.

Overly arched brow from Botox from 6 days ago.

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