Can a frozen forehead with drooped eyelids be fixed with eyebrow lift?

Question

I recently had Botox in my frontalis muscle and although I'm only 30 and they injected fairly high a feel that I've been left with hooded eyelids and struggle to apply makeup. If the frontal is is completely frozen will getting a brow lift using Botox in the orbicularis help?

Zoran Potparic, MD · Answer

You have obviously had your Botox done by someone who doesn't understand dynamics of brow lifting and brow depressing muscles in the forehead and around the eye. The best way would be to wait until paralysis of muscles is diminished (3-4 months) and your eyebrow will be back in pre-treatment position. Try to avoid having Botox placed in lateral (outside) portion of the forehead which will preserve the function of frontalis muscle that lifts  brow and also preserve some motion in your forehead when your animate. Frozen forehead doesn't look good when you are having a conversation.For those that are in rush to fix this problem a small amount of Botox (Xeomin, Dyspor) 2.5-5 units per side injected in the area bellow the lateral aspect of brow to weaken orbicularis occuli muscle which pulls brow down may be helpful.Try to find yourself an experienced plastic surgeon for further Botox treatments.

John Bitner, MD · Answer

Brow drop is a common problem when Botox is injected too close to the brow.  I disagree with the other doctor and feel that adding is sometimes a solution.  If you think of the brow as the middle of a tug-of-war, the frontalis (forehead muscle) pulls the brow up and the orbicularis (muscle around and on the sides of the eyes) pulls the brow down.  You have had the frontalis weakened with Botox and now the tug-of-war is being won by the orbicularis, that is why the brow is being pulled down.  If you now weaken the orbucularis, sometimes the brow will come up. It only takes about 7-8 units total to do a chemical browlift and the injection is done right underneath the brow.  Depending on how paralyzed your forehead is, I would give you fairly high odds that the brow will come up with that, for a relatively low cost or risk.  I hope that explanation helps.

Kenneth E. Morgenstern, MD · Answer

The best solution in this situation may be to wait until your previous dose has worn off and start from scratch, being cognizant of the fact that you received too high of a dose previously.It would not be advisable to pursue a permanent surgical solution to address this temporary problem.

William Portuese, MD · Answer

A frozen forehead from Botox should not be addressed with a Surgical eyebrow lift, until the Botox has worn off. It's important to evaluate the strength of the elevator and depressor muscles of the forehead, the brow position, and hairline prior to embarking on a Surgical  brow lift procedure.

Ronald V. DeMars, MD (Retired) · Answer

Obviously the botox effect is too low if you are having increased hooding of the eyelids. That effect will be gone in a few months. Best not to add more at this time.

Can a frozen forehead with drooped eyelids be fixed with eyebrow lift?

Answers (5)

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