Uneven Results on Forehead with Botox?

Question

Had botox two weeks ago to my forehead in between brows and to my crows feet. The botox appears to have worked more on one side than the other and does not reach to my eyebrows, as a result I look as if I have a scar above my right eyebrow but it is actually a line, above my left eyebrow it is less noticable but it looks slightly dented, I went back to my Doctor who stated she cannot put in more botox as it will cause my eyebrows to droop and to put a filler in the bit that appears like a scar?

Michael Horn, MD · Answer

If your results from botox are uneven, a touch up can frequently be performed to even the results. The eyebrow position depends on muscles which raise or lower the eyebrow. By weakening certain muscles, the eyebrow position can be altered. Too much Botox near the eyebrows or compared to botox in muscles that lower the eyebrows results in lowering of the eyebrows.Fillers can sometimes help fill deep creases which are not completely removed by Botox.

Sam Naficy, MD, FACS · Answer

It's very difficult to answer your questions without first seeing pictures of the areas you are describing. Sometimes it takes only a couple of units to correct residual activity - and filling a line created by Botox (if that's what it is) probably isn't appropriate in this case.

Jeffrey Zwiren, MD · Answer

The corragator muscle is interwoven with the frontalis muscle. The corragator muscle creates the vertical glabellar creases and this muscle is a depressor of the inner aspect of the brow so this muscle will cause an elevation of the medial brow. If the injection is performed too high or if the Botox spreads superiorly then the frontalis muscle can be effected and this causes the brow to drop. Conversely if the central brow is injected and no botox is used laterally then you get a metaphisto or devil's brow.

Cameron Rokhsar, MD, FAAD · Answer

I would not recommend dropping the unaffected brow to the height of the other, and I would not recommend a filler because the filler will likely stick around longer than the problem itself. It's not a good idea to fight unhappiness with one procedure with a new one that will potentially cause a new problem. Try to hold out until the Botox starts to disappear before you decide what to do next. A few months is a small amount in the totality of your life.

	Best of luck!

Benjamin Barankin, MD, FRCPC · Answer

Botox in trained and experienced physician hands typically give nice and symmetric results. That said, sometimes the results are less than optimal. For the new wrinkle/dent you are describing, a little bit of filler can be quite helpful and it will settle out typically over a couple months even if you did nothing.

Uneven Results on Forehead with Botox?

Answers (5)