Can anything be done to fix bad botox results? I ended up with the dreaded 'Dr Spock' brow. (photos)

Question

I had botox just over 2 weeks ago, once it took effect, I ended up with the dreaded 'Dr Spock' brow. But also, a drooping, heavy brow in the middle? I had 20 units in my frontalis and 20 units in my glabella. I went back 2 days ago and had a top up of 8 units. 2x2 units above each brow arch, I feel this has made me look even worse?! Is there anything that can be done to give my eyes a more softer look? My eyelids seem to have gone very low and heavy also. Any advice would be much appreciated.

Blue Medi Spa - Sherman Oaks - Account Suspended · Answer

Hi, from the photos you provided, it seems like the lateral forehead is left untreated. if just a couple of units are injected in that area, it will help to soften up the arches. 
-Melody PAC

Mary Anne Fuchs, MD · Answer

Many clinicians and patients seem to like this exaggerated lift, but I agree with you that it tends to look unnatural.  It might look fine at rest, but when the brow is raised, it looks "Spock"-like, and is a tell-tale sign that you have had botox.  Generally this can be avoided by strategic placement of Botox.   20 units is a lot for the frontalis muscle in my opinion, and in your case, it seems to have been concentrated in the middle 2/3 of the forehead.  At this point, you have 2 options.  One, you can have your clinician inject more in the lateral aspect of the forehead, particularly lower, near the peak of the brow, but this will have the effect of dropping your lateral brow slightly at rest, so small increments are best. The other option is to wait it out.  The results of botox usually do soften a little after 3-4 weeks, so it might not be as noticeable in a few weeks.  To avoid this in the future, I would recommend fewer units and to place the units in a way that the effect tapers more gradually to the sides.

Monika Soni, MD · Answer

Thank you for your question. This can easily be corrected by injecting just a few units of Botox into the frontalis muscle above each lateral brow. It is always advisable to see an expert injector to avoid such complications. Best of Luck!

Chandra Prasad, MD, FACS · Answer

Hi there.  What happened to you has happened to almost any experienced injector of neurotoxins.  It is always important to warn all newcomers to Botox that this may occur and that is why we always have a follow up visit to see how it looks.  If there is a "Mr. Spock", then just a few units in the muscles of the forehead that pull the eyebrow will usually fix it.
Hope that helps!  Good luck.

Kurt Kuhlman, DO · Answer

This is a very easy fix. 1-2 units of Botox injected into the frontalis muscle above each lateral brow should take care of your Spock brow.

Melvin Elson, MD · Answer

The Spock look or Mephisto occurs because doctors are not trained correctly and dont inject the forehead lateral enough and it is easily corrected by injecting the muscles on the lateral forehead to relax them

Mehdi Sina, MD · Answer

Hi,This is easily corrected by injecting a small amount of botox just lateral to the peak of the brow. ANy competent injector will be able to correct this without difficulty.Best,Mehdi Sina, MD

Amiya Prasad, MD - Account Suspended · Answer

Thank you for your question. You had Botox done, which ended up causing “Spock” brows, and adding additional Botox appeared to make your eyebrows even higher, while the middle of your brow descended further.
I can certainly help guide you, without the benefit of a physical exam. I’m Dr. Amiya Prasad. I’m a Board Certified Cosmetic Surgeon and Fellowship Trained Oculoplastic Surgeon. I’ve been in practice in Manhattan and Long Island for over 20 years. As an Oculoplastic surgeon, I’ve been administering Botox to patients before it was used for cosmetic purposes, so I have a lot of experience with it.
It isn’t clear in your question what you were trying to accomplish with Botox treatment. I’m assuming you were trying to improve the glabellar lines and forehead lines with treatment. Placing Botox in the frontalis muscle will relax it. As the frontalis muscle lifts the brow, relaxing or reducing the activity of this muscle with Botox can cause the brow to descend. You indicate that Botox was placed at the center of the eyebrow arch, so it sounds like placement was concentrated in the middle of the forehead, or the middle of the brow. The neurotoxin may have affected the glabella and other depressor muscles in the middle of the forehead, adding to the downward movement. However, the outer aspects of the frontalis may not have been affected by direct injection, and raised the outer corners of the eyebrows as the outer frontalis is working unopposed by the depressor muscles.
With a physical exam, it is possible to add Botox to the outer aspects of the frontalis to cause it to relax, and bring your outer brows down. As for the center of your forehead, it may be best to let the neurotoxin effect  fade, and treat this area more carefully so you can improve glabellar and forehead lines, but not cause the center of the the brow to descend too much.
I think it’s important to have this discussion with your practitioner. If you are not satisfied with their knowledge of the muscles in this area, as you didn’t indicate whether it was done by a doctor, nurse, or technician, you may want to consider a practitioner who knows more about the muscles in the forehead and brow to achieve better balance. I hope you found this information helpful. Thank you for your question.

Can anything be done to fix bad botox results? I ended up with the dreaded 'Dr Spock' brow. (photos)

Answers (8)

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