Uneven Results on Forehead with Botox?

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?

Doctor Answers 8

Forehead botox

To avoid the eyebrow from descending too much, I also avoid the lowest portion of frontalis muscle and explain to patients that some movement will make it look more natural and therefore there may be a line above the eyebrow that is present from activation. As for your other issue, an exam in person is key to assess it.

New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

Uneven botox

Asymmetry of the brow can occur if the amount and location of Botox or Dysport differ on each side of the forehead.  It is important to exercise caution when injecting close to the eyebrows to avoid dropping the eyebrows down, which often is not a desirable look.  However, if you have an obvious asymmetry, a small amount of botox or dysport can be carefully placed to even this out.  Another way to avoid this problem in the future is to only lightly treat the forehead to avoid a line of demarcation of functional muscle and non moving muscle.  You may not be able to smooth all your wrinkles, but your look would be more natural. Without any photos its hard to give any specific recommendations. For good and for bad, the effects of botox wear off around 3 months, so none of these changes will be long lasting.  

Jessica Kulak, MD
Fairfax Facial Plastic Surgeon
4.6 out of 5 stars 27 reviews

Botox and complications

Sometimes if a physician goes lower than 2 cm measuring from the top of the eyebrows, he or she can run the risk of dropping them. It is very difficult to relax the lines that are right above the eyebrows, and most physicians don't usually inject that low in order to prevent that complication. In fact, if you do not inject symmetrically on the forehead you can get a raise in the lateral aspects of the brow giving you what we call "The Spock" look (most people don't like this and it can look funny). I always make sure to warn patients of this prior to getting Botox or Dysport because i don't want them to be unhappy if they have a smooth forehead with some lines above the eyebrows. Its just took risky. I agree with putting a very small amount of filler such as Belotero to soften those indentations/lines if they truly do bother you. Try a small amount of filler and see how it looks. If you do not like it, the good news is that it wear off in a few months. Hope this helps!

Stacy Chimento, MD
Miami Dermatologic Surgeon
5.0 out of 5 stars 2 reviews

Uneven eyebrows after a Botox injection

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.

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 19 reviews

Unilateral Brow Droop After Botox

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! 

Cameron Rokhsar, MD, FAAD
New York Dermatologic Surgeon
4.5 out of 5 stars 35 reviews

Uneven Botox Results

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.

Michael Horn, MD
Chicago Plastic Surgeon
4.4 out of 5 stars 54 reviews

Uneven forehead with Botox

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.

Benjamin Barankin, MD, FRCPC
Toronto Dermatologic Surgeon
4.8 out of 5 stars 50 reviews

Botox and residual activity

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.

Sam Naficy, MD, FACS
Seattle Facial Plastic Surgeon
4.7 out of 5 stars 221 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.