Brow and eyelid heaviness a few weeks after Botox for migraines, is this normal?

Botox can be a great solution for chronic migraine sufferers.  However, because of the amount and placement of Botox normally used by Neurologists, it is commonly associated with brow heaviness or drooping in patients.  The placement of the injections tends to be not in the best location for cosmetic results.   Sometimes, additional injections into the frowning muscles may alleviate this.   It may be best to try a lower dose in the forehead next time and see if that is as effective for the migraines.

Heaviness should resolve in a few days, if heavy after a few weeks it likely will stay that way for a few months till fully worn off.  Best, Dr. Emer.

Thank you for your question.  Brow heaviness after Botox treatment can be either physical or subjective.  Sometimes the treatment was more than adequate and sagging of the brow can occur.  Other times, it is appropriate and the brow looks good but the patient has a sensation of heaviness.  In this instance one would infer that the sensation is due to not moving the brow and as such one would expect to get acclimated to it and not be an issue.  On the other hand, if the brow is sagging then the treatment may need to be adjusted. 

The development of brow and/or eyelid heaviness after Botox is dependent mainly on the placement of the injections but can also be influenced by the dose used.  Without knowing exactly where your injections were placed and the dose used to treat your migraines, it is difficult to answer your question.  It may be possible to adjust the placement of the injections and/or the dose used to prevent the brow and eyelid heaviness you are experiencing.  I would discuss this with the physician who treated you.  

Unfortunately, this is relatively common when Botox is being used to treat migraines. It happens for two reasons. Migraine treatments generally use a higher dose of Botox, and neurologists tend to focus more on the migraines themselves when they inject, and less on the aesthetic outcome. In my practice, I have many migraine sufferers who prefer the techniques that we use as an aesthetic practice to those used by their neurologists for this exact reason. However, neither approach is wrong, they are just different styles. If this does not bother you, and you are feeling relief from your migraines, then there is no need to do anything differently!