Strange Scalp Muscle Sensation on Top of my Head Following Botox Injections in my Forehead.

Question

I had Botox 3 days ago (about 32cc?) to provide forehead lift. I'm having the opposite: forehead droop in the area over my eyes giving me a tired look. Sadly,this cosmetic consideration is the LEAST of my concerns. What's more worrisome is that I'm now experiencing odd muscle sensations along the very top of my head. If I touch my forehead in the area just above my left brow arch I have the sensation of tugging on something below the skin that goes up and over the left side of my head! WTF?

Ron Shelton, MD · Answer

You should speak with your treating physician to determine what you are experiencing as their can be confusion and inaccurate evaluations on line from physicians who are not examining you, nor understanding exactly where the Botox was injected.  You mentioned (with a question mark) ccs but probably meant units.  The doctor might have injected your glabella between the eyebrows with easily 25 units which helps lift the forehead and at the same time minimizes the "11" of the forehead.  A few units at the tail of the eyebrows also helps lift the forehead. So depending on who the doctor is and the muscles they choose to inject, 31 units could be an appropriate dose for glabella, crows feet and a beneficial side effect of forehead lifting.  The droop could be if the injections were placed in areas of the forehead that were being used preBotox to keep droopy eyelids up.  If there is "hooding" it is not uncommon that forehead Botox will lower the forehead muscle and along with it, the eyebrows and eyelids. The symptoms of the fullness of the upper eyelid and the sensation of the area north of the treatment may indicate some sensory nerve (suprorbital) irritation from the medicine being close by and that the Botox might have been placed too low near the eyebrow making the upper eyelid saggy. This should all go  away in time but can take many weeks to a few months.

Harold J. Kaplan, MD · Answer

Hi Seattle.  As Dr. Taylor suggests, we would recommend scheduling an appointment with your injector to review your results.  While ptosis lid or eyebrow heaviness) does not happen often for experienced injectors, it is a common side effect for Botox.  If it's not that pronounced it should resolve in a month.

	As for the tugging sensation you feel in your forehead, we do have patients describe a tightness in the forehead after injections.  It's normal for the forehead to feel a bit different after injection including tightness.

Harlow Hollis, MD · Answer

I guess you mean 32 units. Eyebrow lifts (same as forehead lifts) result from Botox injected in specific areas below the eyebrows and never require 32 units. Frown lines treated will use 32 units approximately but this is different from lifts....it is for frown lines. The droop of your forehead suggests too much Botox in the Frontalis forehead muscles which is where we inject to reduce transverse forehead lines. Usually about 14 to 16 units is all you need for this. The odd sensation may just be needle injury to your supraorbital nerve (it gives sensation to your forehead and scalp) but since the needle is so fine/small you probably will recover nicely on your own. Discussing all this with your injector would be wise, especially if you were looking for eyebrow lifts but got eyebrow droop. Be sure you deal with someone who has experience as this result should be very uncommon with an experienced injector.

Jacqueline Calkin, MD · Answer

Sounds like you had the horizontal forehead lines treated as well as possibly the frown lines. If your main goal was a forehead lift, this was too big a dose. I wouldnt be overly concerned about the symptoms. Likely just your muscles "getting used to things" however, I like the others who have answered the question, do question the experience of your injector. With Botox, less is often more.

Mark Taylor, MD · Answer

Check back with your doctor in a week to 10 days.  At that time you should be able to see the final results of your Botox treament.   If you still have concerns at that point, you will be able to discuss option with your doctor.

Strange Scalp Muscle Sensation on Top of my Head Following Botox Injections in my Forehead.

Answers (7)

Answer: 32 units Botox is much too high a dose for a Botox Brow lift

Answer: 32 units Botox is much too high a dose for a Botox Brow lift

Answer: Check back with your doctor in a week to 10 days.

Answer: Check back with your doctor in a week to 10 days.

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Strange Scalp Muscle Sensation on Top of my Head Following Botox Injections in my Forehead.

Answers (7)

Answer: 32 units Botox is much too high a dose for a Botox Brow lift

Answer: 32 units Botox is much too high a dose for a Botox Brow lift

Answer: Check back with your doctor in a week to 10 days.

Answer: Check back with your doctor in a week to 10 days.

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Recommended reading

Everything you need to know about Botox

Our mission is to create a world where every investment in modern beauty is Worth It.