Is it normal to have V formation in forehead 72 hrs after Botox? (photos)

I usually recommend that my patients wait 10 days to let the treatment fully take effect.  Any early adjustments can make the brow look overly heavy, or may not achieve the desired result because the final result is still evolving.  If patients are not satisfied with the results after 10 days, adjustments or touch-ups might be possible depending on the patient and their goals. Be sure to use an expert physician injector.All the best,

Hi,Thank you for your question and sharing your photos.I encourage you to wait 2 weeks as it takes about 2 weeks for the full effect of botox. The forehead muscle may continue to relax over the next few days. Early touch ups can result in forehead heaviness. If you're still having a contour irregularity when raising your eyebrows at 2 weeks, a few more units can be injected to relax the lower part of the frontalis muscle.Hope this helps!

Thank you for your question and sharing your photos. I encourage you to wait 2 weeks as it takes about 2 weeks for the full effect of botox. The forehead muscle may continue to relax over the next few days. Early touch ups can result in forehead heaviness. If you're still having a contour irregularity when raising your eyebrows at 2 weeks, a few more units can be injected to relax the lower part of the frontalis muscle.

Thank you for your question and for sharing your photographs funkmstrbeth. I understand your concern. Botox is a purified protein used to address wrinkles associated with facial expression. When injected into the skin Botox will relax the muscles and smoothen out the overlying wrinkles. The most common areas of treatment are in the upper face. These include the horizontal lines seen on the upper forehead when one raises the brows, the vertical lines seen between the brows when one frowns (frown lines), and the crow's feet seen around the eyes when one smiles.It is difficult to make an assessment without a formal exam in the office where I can view the skin in multiple angles and observe wrinkles formed with facial expression. However, I hope the information provided here is useful.The pivotal studies used 20 units of Botox in the forehead area above the brows to address the horizontal lines seen when one raises the brows. These studies demonstrated that the peak results are seen 14 days after the treatment and most people enjoy their results for 3-4 months. At that point, a maintenance treatment is recommended. While some people start to see results as early as the next day, it can take two weeks for full results so patience is important. We have our patients return two weeks after their treatment to assess their results via photographs. At that time additional units may be added if necessary.When patients present with concerns about specific wrinkles in the upper face such as the frown lines, I always assess and usually treat the other wrinkles in the upper face including the horizontal forehead wrinkles and crow’s feet. The reason is to maintain a harmonious and natural balance to the appearance of the upper face. The muscles in the glabella which are responsible for the formation of the frown lines serve to pull down on the inner brows when a person frowns. Similarly, the muscles around the eyes which are responsible for the formation of the crow’s feet seen when smiling (orbicularis oculi) are also responsible for pulling down on the brows, but in this case the outer brows. On the other hand, the muscle in the upper forehead which is responsible for the formation of the horizontal forehead wrinkles when a person raises the brows (frontalis) serves to pull the brows upward. If one of these muscles is relaxed with Botox and the others are not, the other muscles will still be active. This will lead to an unbalanced and unnatural appearance of the upper face where the brow can be elevated, depressed, or uneven in shape or position. Therefore, I recommend that my patients take a global approach to the upper face when receiving Botox treatments and treat all three of these areas. Sometimes bunny lines on the bridge of the nose are also treated.If I had a patient with the concern described here, I would recommend that she wait a full two weeks prior to assessing the results. At that point additional units may be added if necessary.With any injection, there are risks such as pain, bleeding, bruising, redness, swelling, tenderness, and infection. We take special precautions to minimize these risks such as using a painless technique. We also treat bruises with a laser as early as the next day. Bruises usually resolve within two weeks if untreated. After a laser treatment bruises usually resolve in 1-3 days, but may still take two weeks for full resolution. In addition to these risks, with Botox there is also a risk that the product spreads or diffuses to nearby structures. Spread to nearby muscles can lead to side effects such as the temporary appearance of droopy eyelids or a temporary asymmetric smile.

After a Botox treatment, I recommend that my patients avoid heat exposure, alcohol consumption, and strenuous exercise for 24 hours and not lie down flat for four hours. This is because all of these activities may possibly lead to the movement of the product and consequent side effects such as droopy eyelids. Although there have been no definitive studies shown that these actually occur and some physicians do not provide such aftercare instructions, in the absence of data I err on the side of caution and recommend that my patients avoid such activities.

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

It takes two full weeks to see the results of Botox and in between it can often appear a little asymmetric. I always have my Botox patients follow up two weeks to see the full results.  Please consult an expert in Botox for the best cosmetic results. Best, Dr. Green

Botox will start to set in around day 3. However, final results will take a complete 14 days. Until then a person can see slight asymmetries and muscle strength variances. A post Botox appointment in 14 days should be set up. At this appointment, your results will be evaluated.

Thanks for posting the question and descriptive photos. Currently, only your low frontalis muscle is firing... the upper part has been relaxed --> leading to a V formation.  It is possible the low frontalis settles in the coming 7-10 days. After 7-10 days, I would return to your injector for some additional botox in the low lateral (side) of your forehead to better balance your forehead muscle. Good luck!! 

72 hours is early out, so you are not seeing the final effect yet.  Having said that, consult with your provider - the photos suggest that the top of the forehead is "fixed" while the brows can still move up.  They may suggest waiting a few more days, or coming in earlier than planned, based on what injection points were used and what dose was used.

I would give it a few more days and if nothing changes, return to your treating physician for evaluation and possible additional Botox. Good luck from New York City

Final results for Botox can take up to two weeks to be seen.  I recommend giving it a little more time.  If after two weeks you still have concerns, return to your injector for a touch up.