Spock brows 1 month after glabellar Botox - what can I do to correct this? (photos)

Question

Hi all, I am an asian female in my mid-20s. A month ago, I received glabella botox in hopes to treat my chronic frowning. However, my brows have turned really arched and “spock-like”. My middle forehead is heavy, I can’t lift it and when I raise my brows they look even more ridiculous. I was not expecting such an effect as I thought my procedure would only treat my frowning muscles. Is there anything I can do to mitigate this?

Nima Shemirani, MD · Answer

Hi @Diligent846365! This is easily treatable.  This occurs when the wrinkle relaxer (Botox) is injected only at the central part of the upper forehead. When the central forehead is weakened and the outer sides remain active, the central brow to drop and the outer brow to appear like it's lifted too high. You can go back to your licensed practitioner and they can add 1-2 units above the arch of the eyebrow.

Jason Emer, MD · Answer

For unique cases where a variety of modalities could be used to treat the condition, I would suggest an in-person or virtual consultation to develop a custom and effective treatment plan.  It is difficult to precisely define the best option without collecting the same information. I suggest reaching out to an expert for a consultation with surgical and non-surgical methods to get a comprehensive option. Best, Dr. Emer.

Ryan Rebowe, MD · Answer

The "spock" brow deformity is caused by utilizing the neurotoxin to treat only the middle part of the frontalis muscle, leaving the lateral aspects to move and raise the brow in an unnatural manner. This lateral brow area can be injected to lower the brow slightly. However, this is ideally performed within two weeks of the original injection. Getting additional injections one month out risks the new injections lasting longer than the original, which could cause your brow to droop. I would ask your injector for only a small amount of lateral forehead toxin to keep this effect from happening.

Andrew Miller, MD · Answer

When the outer eyebrow is going up too high after Botox, you should be able to go in for a touchup to inject into some of the muscle that is lifting that outer eyebrow up. Then it should settle down nicely.

Mathew C. Mosher, MD · Answer

Asymmetrical or too severe arching of the lateral brow can occur even with expert injectors. Fortunately the tendency towards this occurring is predictable and if it occurs it is easy to remedy. Our patients are encouraged to allow the results from treatment to evolve for two weeks and then to let us know when small issues like you are experiencing occur. Rather than going online you should call your physician provider and see if they can help you. If not, then you should consider a more experienced and credentialed provider.

Best regards, Dr. Mosher

Best regards, Dr. Mosher

Eric M. Joseph, MD · Answer

Based on your photos, your right eyebrow is naturally a bit higher than your left and this may have bean exacerbated after your BTX. The key to improving your situation may be to target the frontalis muscle that is lifting your right brow a drop higher. If you’re not confident with your doctor, consider getting a second opinion. If you can live with it, the negative effect may lessen significantly over the next 3-4 weeks. Hope this helps! Dr Joseph

Nelson Lee Novick, MD · Answer

A couple of microdroplets of additional Botox placed appropriately in the lateral Forehead can lower the "Spock Eyebrows." Alternatively, since Botox effects are temporary, you can simply wait the 3-6 months until the glabella forehead Botox effects go away. Thereafter, make sure to consult with an experienced, board certified cosmetic dermatologist. Best of luck.

Amir Mortazavi, MD · Answer

Thank you for the pictures and your question. This is likely from an uneven treatment done by your injector. You should make a follow up appointment or go over this result with the injector as a small amount of botox in the forehead muscles can improve the appearance and your facial symmetry. As a genral rule its recommended to treat both the frown lines and forehead during the same treatment.

Camille Cash, MD · Answer

Good news!  This issue you are experiencing after your Botox treatment is correctable.  Return to your injector for a small dose to adjust your results and correct your concerns.

Kurt Kuhlman, DO · Answer

Your injector inadvertently injected Botox into your frontalis muscle instead of your Glabellar muscles. This is why your middle forehead is heavy and this caused your medial (inside) brow to drop. As a result, your lateral (outside) brow looks like it raised (Spock brow). Your lateral (Spock) brow did not get higher - it stayed the same - but it looks raised because the medial brow lowered. You can put a few units of botox above your lateral brow to drop it, but I would just wait a month for the medial brow to raise to its normal level. Your injector most likely injected too high and too superficial in your Glabellar muscles. Experience and proper training, not the specialty of your injector is what matters.

Spock brows 1 month after glabellar Botox - what can I do to correct this? (photos)

Answers (12)

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