How soon can I go back after Botox to fix Spock brows?

I got botox 5 days ago in my 11's and 4 units in my forehead. But I think because I didn't get any injections above the middle of my eyebrows and out, I'm getting a very odd raised arch look. How soon after my first round of botox (5 days ago) can I go back to fix these spock brows??

Doctor Answers 20

Correction of Botox

Thank you for your question HC155. I am sorry to hear about your situation. Botox is a purified protein used to address wrinkles associated with facial expression. The pivotal studies demonstrated that the peak effects of Botox are seen 14  days after the treatment. In our office we have patients return at that time to assess the results. At that point more Botox can be placed in certain areas for correction. 

Please consult with a doctor for specific recommendations. Good luck!


Encino Physician
5.0 out of 5 stars 1 review

Spock or peaked eyebrows following Botox

Dear HC155:

The "spock" or peaked brows seen commonly are due to an imbalance between the weakening of the orbicularis oculi (round) muscle around the eye / lateral aspect of the corrugator muscle and the frontalis (brow lifting) muscle of the lateral forehead following Botox injection. 

I ask my patients to return during the 2nd to 3rd week following injection (as this is the optimal threshold of Botox function) should this imbalance occur as it is easily corrected at that time. Should it be anticipated at the time of initial injection and injected for, it could weaken the eyebrow to droop and  it is most difficult to correct until the Botox has "worn off".  It is possible during this 2 week waiting period that the peaked eyebrow will auto-correct as the frontalis muscles pulling the peak catch up in their relaxation. 

I hope this is helpful. All the best!

Dean P. Kane, MD, FACS
Baltimore Plastic Surgeon
4.8 out of 5 stars 70 reviews

Spock Brow

The development of a "Spock" appearance to the eyebrows that you describe can occur when botox is not injected in a balanced fashion in the forehead. The good news, is that the situation is very easily correctable with a few more units to the lateral aspect of your forehead to eliminate the Spock eyebrows. There is no need to wait for correction. You should be able to contact your injector and get a touch up anytime. Thanks for your question.

Amit Bhrany, MD
Seattle Facial Plastic Surgeon
5.0 out of 5 stars 11 reviews

Spock appearance after Botox

  • remember that Botox injections halt the activity of the muscles injected.  Where you describe the injection sites,it seems the forehead over where your brow is peaking wasn't injected.  This can happen even in the most experienced hands.  This is easily fixed and can be done at two weeks.

Jeffrey Joseph, MD, FACS
Lafayette Facial Plastic Surgeon
5.0 out of 5 stars 4 reviews

Brow Shape and Botox

The most common unwanted effect of treating the "11's" with Botox is the shape change you are describing.  The reason is somewhat complicated, which is the reason that it is so important to have your Botox treatments by an experienced injector.  It should be stated that even an expert at Botox can have a patient with this problem on rare occasions. 

In general terms Spoked brows happen because the Botox has caused the medial (close to the nose) area of the brow to droop.  When that happens your brain goes to work to try and lift the brows.  The medial part cant lift (in the case where it is drooping) but the lateral part of the brow (closer to your ear) can.  Hence the shape that has occurred. 

You have two options for treatment.  One is to just wait for the Botox to wear off at which point your brows will return to the normal shape.  The other is to get a light treatment of Botox above the raised part of your brow.  That will improve the shape, but you eyebrows maybe droopy overall at that point.  Of course that too will correct itself after the Botox wears off.

Hope that helps.

Marc Cohen, MD
Philadelphia Oculoplastic Surgeon
4.8 out of 5 stars 24 reviews

Spock Brows

"Spock" brows happen when Botox over the lateral eyebrow is avoided . This happens often on the first time because the doctor is making sure not to relax your brows too much and it is difficult to know ahead of time how your brow will respond to botox. If you are noticing "Spock" brows, it is reasonable to call your doctor and get in any time. It is really a very simple fix of just a couple extra units of Botox. 

I hope this helps!

Dr. Quenby Erickson


Botox touch up now or wait?

Thank you for your question HC155. You concerns are understandable and can happen. Typically after Botox is injected a follow up visit two weeks after the injection would be appropriate to assess the Botox at its full effect. If small adjustments are needed at that point they can be made which in your case sounds like a few units extra would be placed more laterally to soften the "Spock Brow". Moving forward your injector can note the changes to make your "Botox plan" more perfect. 

Paul Pietro, MD
Greenville Physician
5.0 out of 5 stars 3 reviews

Goodbye Dr. Spock-Botox and Venus Legacy

You can go back now for a touch up of Botox to address the arch. Venus Legacy treatments could help soften the look as well. See an expert. Best, Dr. Emer

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.9 out of 5 stars 165 reviews

Spock brows

These occur because doctors do not inject the forehead lateral enough. The training is incorrect and this is what happens. You can go back now and get treated in the lateral forehead area for correction

Melvin Elson, MD
Nashville Dermatologist
5.0 out of 5 stars 6 reviews

Botox: touching up arched Spock brows

Botox, like Xeomin and Dysport, is a medication injected into target muscles of the face to selectively relax them for fewer/softer wrinkles.

The position of the eyebrow is a balance between a muscle around the eye and the muscle of the forehead. A high arch after Botox is caused by a relaxed muscle around the eye and a contracted muscle of the forehead. To restore balance, a small amount of Botox can be injected into the forehead to relax the eyebrow back down.

I would wait at least 7 days to see the Botox stable at maximum effect. Otherwise you might be chasing a moving target. I offer a follow-up evaluation to all of my patients to tailor their result and better, safer future injections. Safety comes first. 

Victor Chung, MD
San Diego Facial Plastic Surgeon
5.0 out of 5 stars 10 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.