Unable to Lift Right Eyebrow After Botox

Hi, I had botox in between my eyebrows (frown) and in the horizontal lines on my forehead 16 days ago. My right eyebrow barely moves and I can elevate it. My left eyebrow arches up when I try to move it and causes a little "pouch" above it which I don't like. When I try to lift both at the same time, only my left one raises which looks awful. I THINK my right eye lid has slightly drooped onto my lashes but I can't be sure. Will the unmoveable eyebrow correct soon or will I need to wait 6 months?

Doctor Answers 13

Unable to lift brow after Botox

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This is an uncommon side effect, but one seen when under-trained or under-experienced persons are injecting Botox. Fortunately, the effects will wear out after 3-4 months at the most, but often sooner. In the meantime, a dermatologist can even out your appearance and in the future prevent this from happening. ~ Dr. Benjamin Barankin, Toronto Dermatology Centre.

Toronto Dermatologic Surgeon

I have seen this issue before with Botox injections

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I have seen this issue before with Botox injections when administered by those who are not well trained. It
is imperative that your doctor has a very intimate understanding of the muscles of the face. Otherwise, you
run into complications like these. Thankfully, Botox wears off after a few months and you can reapply it with
a licensed professional. In the mean time, be patient, as you will begin to notice increased mobility of your
eyebrow as the weeks go by. In many instances a drooped eyelid recovers in 6weeks-3 months.

Sanusi Umar, MD
Redondo Beach Dermatologic Surgeon
4.6 out of 5 stars 33 reviews

Motionless Brow After Botox?

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Hi Sydney.  As you have seen injecting Botox is not always a trivial exercise.    It sounds like you may have a good result for the right brow, but only if the relaxation of that side has not resulted in eyelid ptosis (sagging) which you also mentioned.

If you still have movement in the left brow, it may be that a bit more product.  As Dr. Huang has pointed out, the look you want to achieve can determine how much product is used so if having your right brow completely relaxed is not what you wanted, you should return and discuss expectations with your injector once more to try and revise it to get it right.

In answer to how long it will last.  It's usually 3-4 months before Botox wears off.

Harold J. Kaplan, MD
Los Angeles Facial Plastic Surgeon
4.4 out of 5 stars 7 reviews

Facial asymmetry after Botox

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It sounds like some of the BoTox spread to your frontalis muscle.  This is not something I see a lot of anymore with BoTox, but can occur when the injection relaxes some of the eyebrow elevators known as the frontalis (forehead muscle).  Usually this effect does wear off much quicker than the rest of the BoTox effect because the "overdose" in that area is modest.  I have had this happen once when Dysport was released to market because it's effect spreads over a larger area.  The effect resolved in 3 weeks in that case.  Good luck. 

Injecting BoTox is fairly easy.  Having someone who intimately understands facial muscular anatomy is essential when dealing with problems that arise from treatments as well as in idealizing treatments!

Michael H. Swann, MD
Springfield Dermatologic Surgeon
5.0 out of 5 stars 12 reviews

Right eyebrow not moving after Botox

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It sounds like the Botox worked too well on the right side and possible not enough on the left side. For the right side, you probably will have to wait 3-4 months for the function to improve.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Unable to Lift Right Eyebrow After Botox

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This is a common problem with Botox injections especially when used by people who are not well trained. In order to really use Botox effectively the injector needs to have intimate knowledge of where the muscles in the face are and what they do. Further, the injector must understand the variability and asymmetries that occur in normal anatomy.  All of this knowledge is then put to use and combined with the experience of the injector to achieve a predictable result. This process can not be learned in a weekend course by someone with virtually no knowledge to begin with.  You should return to your doctor and voice your concerns, a simple fix is to have a small amount of Botox placed above the Left eyebrow to lessen the symptoms. However, you will need to wait for several weeks, usually 6 to 8, to see the normal function return.

Paul Vitenas, Jr., MD
Houston Plastic Surgeon
4.8 out of 5 stars 113 reviews

Uneven and heavy eyebrows after Botox

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Botox seems simple to do on the surface, but a lot of less experienced or less careful injectors can run into exactly this problem. People's muscles are not usually exactly symmetric, either in anatomic placement or sometimes in strength, so the amounts and locations of Botox placement really does remain an art at the higher quality treatment levels.

Unfortunately, it sounds like your injector overdid the dosage for your forehead lines. There are several reasons this can happen, and the experienced injector will warn you before treatment if trying to completely eradicate the horizontal lines may put you at risk of particular eyebrow heaviness. In this case, you may be stuck with a heavy right eyebrow, but not for six months, more like three. As some of the other physicians have said, some additional Botox may be placed to make the look more EVEN, and to fix the left eyebrow crease issue, but it will NOT help the right forehead muscles to regain strength any sooner.

Jessica J. Krant, MD, MPH
New York Dermatologic Surgeon
4.7 out of 5 stars 41 reviews

Asymmetric eyebrows after Botox

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Before I do any BOTOX procedures, I make sure I have a discussion with my patients as to what "look" they want from BOTOX.  Did you want a small eyebrow lift, or did you want to be completely frozen.  If you wanted to be more frozen i.e. no lines and no movement than the right eyebrow is fine.  If you want movement back - you'll have to wait for the BOTOX to wear off.  Regardless, you sound like you are asymmetric.  To make your eyebrows look more the same, you need a little more botox over the left eyebrow.

Dr. Cat Begovic M.D.

Asymmetry of eyebrows after Botox injections

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you may need a little more in the outer left forehead to prevent the Mr. Spock eyebrow, and if the right side has dropped, then you may be able to get a little more lift if more units are injected into the depressor muscles of the glabella (between the eyebrows) and the outer eyebrow orbicularis oris muscle. The drooping will be gone in around three, to four months.

Ronald Shelton, MD
Manhattan Dermatologic Surgeon
4.9 out of 5 stars 38 reviews

Unwanted Botox Effects

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Fortunately Botox is temporary (in spite of some complaints that it does not last long enough!). Some unwanted results will correct in a few weeks, others may take months.

You should have a small dose of Botox (about 2 units) injected above the left eyebrow which should correct part of your problem.

If you are brave enough to try Botox again in the future, have a lower dose injected and have the injections done higher up on the forehead.

Mitchell Schwartz, MD
South Burlington Dermatologic Surgeon
4.7 out of 5 stars 12 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.