Small Amount of Botox to Flatten Facial Scar and when Should I Have Waited to Pluck my Eyebrows? (photo)

On Thursday I had a small amount of botox injected either side of a indented facial scar that sits right above my eyebrow, going up my lower forehead about half an inch. Its fairly small but bothered me because it didn't cover well with makeup (makeup seemed to sink into it making it even more visable!) and showed up in some lights. I plucked my eyebrows last night (Saturday) despite being told to wait about a week and Im worried that I will have affected it. I have an shaping app next Friday.

Doctor Answers 5

Botox is not appropriate treatment for a depressed scar.

Botox is a neurotoxin that is used to paralyze muscles of expression that cause unwanted wrinkles, like frown lines. Unless your corrugator supercilii muscle contraction causes some unusual appearance changes in your well-healed and mature supra-brow scar, paralyzing this muscle will simply reduce your frown lines but do nothing else to benefit your scar.

You either need filler (Hyaluronic acids such as Juvederm or Restylane) to "plump-up" the depression in your scar to a flatter contour that does not catch light and shadow, OR scar revision by a plastic surgeon who can excise the scar and reclose it in everting layers that will remain flat when completely healed, rather than depressed. This takes accurate surgical technique, layered closure, and fine sutures.

Plucking your brow had no ill effect on the effectiveness (or lack thereof) of your Botox injection.

Botox for this indication seems a waste of money. Best wishes! Dr. Tholen

Minneapolis Plastic Surgeon
4.9 out of 5 stars 255 reviews

Botox for scar

I am also somewhat puzzled about the use of Botox for such a scar (3 years old).  It is possible that by taking out the muscle groups around this area may prevent movement in the area and hopefully decrease the possibility of making the scar stand out with muscle activity, but this is not a standard treatment for a mature scar.  Some surgeons are using Botox immediately after closure of a larger surgical defect in the glabellar region.  The theory is that by paralyzing the muscles in the region, there will be less tension applied across the scar, and therefore, less eventual scarring. 

I agree with Dr. Rueckl, that a filler might make it a bit less noticeable but only if the scar is depressed.  Hard to tell from the limited resolution of the photograph.  I see no problem with plucking of your eyebrows.

Curt Samlaska, MD
Las Vegas Dermatologist
5.0 out of 5 stars 4 reviews

Botox for Forehead Scar

I think you will be just fine having plucked your eyebrows 2 days after botox in the area. You look very young, and most likely don't have age related wrinkles between your eyebrows yet. However, it does appear that your scar is over the "frown muscle" called the corrugator muscle. I think putting a small amount of botox there to inhibit the muscle from contracting may help to reduce the scar further. Often times, when a scar forms in an area where you have normal facial lines, it will start to look like a "wrinkle" as you age, and can make the lines look more prominent. Certainly the botox should not hurt anything, and if it helps - great.

Jennifer Reichel, MD
Seattle Dermatologist
4.5 out of 5 stars 42 reviews

Plucking eyebrows after Botox

I'm a bit unsure why Botox was done. Scars are not formed from muscles contracting or moving, but from incisions, cuts, etc. Injecting the muscle isn't going to change the scar there. I would have put filler into it because you want the scar to be the same as the rest of the skin, filled in.

With that being said, we tell patients not to put excessive pressure on their faces after Botox for 24 hours. Plucking your eyebrows is fine and I have no idea why someone told you to wait a week for that!

F. Victor Rueckl, MD
Las Vegas Dermatologist
4.6 out of 5 stars 17 reviews

Botox may not be effective three years after a scar is formed

I doubt that plucking your eyebrows two days or more after Botox above the eyebrows will affect the results. However, three years allows scars to fully mature and I doubt that there is such muscle spasm or contraction that can be relaxed with botox injections that you would see improvement.  Some doctors inject botox for new scars so the underlying musculature doesn't stress or pull the fine scar apart or make it widen. If the bellies of the muscles were severed with the trauma then possibly the botox would make the muscles look smoother and make swellings of the skin adjacent to the scar look less high and not be in as much contrast with the depressed traumatic scar. This treatment would have to be repeated every three to four months to maintain improvement. Sometimes Fraxel laser resurfacing helps these scars better.

Ronald Shelton, MD
Manhattan Dermatologic Surgeon
4.9 out of 5 stars 37 reviews

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