Will 0 Units above my brows give me spock brows? (Photos)

Question

I need to get botox for my glabellar wrinkles because they are static and somewhat deep. My first injector used 8 on the glabella and 0.5 units on each brow. Result was non frozen glabella,and slightly pointier on the arch, especially when raised. She gave me ptosis the second time I went with Dysport. So now I have a new injector who did 15 units on the glabella this time 1 unit on each brow. Result is frozen glabella but noticeably flattened brows. My new injector can’t do 0.5 units above each brow next time. So her suggestion is to try 0. I’m wondering if I’m at high risk for Spock brow? Or if there are any suggestions as to what can be done to help. 31 Female. Thank you!

Laurie A. Casas, MD, FACS · Answer

Hi! 
Your brow shape is very responsive to even small amounts of product, so it’s less about total units and more about precise placement and timing. A good approach is to treat the glabella adequately first and avoid brow injections initially, then reassess at around two weeks. If any peak or imbalance appears, a very small, targeted adjustment can be made to maintain a natural brow shape without flattening or creating a “Spock” effect.
Hope this helps

Jeffrey H. Spiegel, MD · Answer

Spock eye to those that are new to Botox means an arched eyebrow following Botox injections to the 11s and forehead. It can easily be corrected with minimal amount of effort. There is no magic wand to avoid it at all times. Sometimes it just means an additional half to one unit above the brow. What I suggest is to go to the same Injector you like and trust which will know your anatomy and customize your treatment. Best from Boston!

Behnoush Zarrini, MD · Answer

In my experience, Spock brow happens when the central brow depressors (the glabella complex) are relaxed but the lateral frontalis is left relatively unopposed. So yes, if you treat the glabella and place 0 units above the brow, there is a possibility of lateral over-elevation, especially in patients who naturally recruit their forehead to lift. That said, it is not inevitable. Your prior outcomes suggest you are sensitive to small changes, which means your injector needs to think in micro-adjustments and precise placement, not just total units. The flattening you experienced with 1 unit per side tells me your brow balance shifted the other direction leading to too much suppression of lift.
The safest approach is not chasing a fixed number like 0 or 0.5 units, but customizing based on your muscle pattern. In cases like yours, I often treat the glabella adequately for static lines, then reassess at 10–14 days and add a very small lateral adjustment only if needed. This avoids both Spock brow and over-flattening. Given your history of ptosis with Dysport, conservative dosing and careful injector technique are critical. The goal is controlled relaxation with preserved expression&mdash;not a frozen or distorted brow shape.

Anna Chacon, MD, FAAD · Answer

If you are receiving 0 units above the brows, then by definition you are not weakening that area, so the risk of “Spock brows” from that specific adjustment is actually low.

The “Spock brow” appearance usually happens when:

The outer brow elevators remain active
While the central forehead is over-relaxed

In your case, the more relevant factor is the glabella dosing, not the brow injections themselves.

Since you’ve already experienced variability in response (including ptosis once), your injector is likely being appropriately cautious.

If brow shape becomes an issue, adjustments are usually made by:

Fine-tuning glabella dosing
Balancing forehead muscle activity
Very small, strategic lateral brow treatment if needed

Botox/Dysport outcomes are highly individualized, so it often takes a couple of cycles to find your ideal balance.

Skin Social · Answer

This sounds pretty normal anatomically! You likely didn’t get enough Dysport in your glabella the first time, which caused the slight Spock effect, while the second treatment relaxed things more completely but flattened your brows a bit. 
Trying the glabella only next time (without brow units) sounds reasonable and doesn’t necessarily mean you’re at higher risk for Spock brow. Many injectors, myself included, prefer to undercorrect first and add a tiny touch-up later if needed rather than over-flatten the brows from the start.
Since you’ve had ptosis (drooping) before, conservative dosing is probably smartest for you! Additional units could always be added in the future, depending on your results. I hope this helps!

Flaviu Sebastian Deme, MD · Answer

Probably not “high risk,” but you do sound somewhat prone to lateral frontalis dominance when the glabella is treated and the frontalis is left untouched. That’s the mechanism behind Spock brow:glabella muscles are weakened,central frontalis weakens relatively more,lateral frontalis still pulls strongly,outer brow spikes upward.But your first result sounded mild (“slightly pointier”), not dramatic. That matters.
One very common strategy is:treat glabella conservatively,wait 10–14 days,add a tiny touch-up only if Spock actually appears.That avoids committing upfront to brow flattening.

Camille Cash, MD · Answer

From your description you are very sensitive to even small doses of Botox.  You may be okay not treating the brow area since such a small amount has been used in the past.  If you find a "spock brow" developing you can return for a touch up to soften it.  Be sure to use an experienced injector as placement of the product will be key for you due to your sensitivity..

Will 0 Units above my brows give me spock brows? (Photos)

Answers (7)

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