Botox Brow Lift Vs Thermage for the Eyes?

What is the difference between a Botox brow lift and Thermage for the eyes?

Doctor Answers 20

Botox very effective for brow lift.

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1)  Thermage is useful elsewhere, but we don't think it is very effective in the upper face.

2)  Skillfully injected Botox can really produce a Chemical brow lift (about 30 units).

Manhattan Plastic Surgeon

They Work Differently & Have Different Results

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Hello Bobbi,

As basic overview here are the differences:

Botox : is an injection that works by paralyzing the muscles that pull the brow down. As a result the muscles which lift the brow are unopposed and the brow lifts up. By controlling the amount of Botox injected and by accurately injecting specific muscles, very nice results can be achieved. Typically the wrinkles between the eyebrows are also improved along with the brows. Results last anywhere from 3-6 months.

Thermage: is a device which generates heat (radiofrequncy energy) that tightens the skin by affecting the collagen in the skin above the brow. Results can be subtle and often requires more than one treatment. Thermage tends to work better in younger patients with healthy skin. The satisfaction level with Thermage tends to be low, but in those who it works for the results last longer than Botox.

Of the two I recommend Botox. If you are not against surgery than an endoscopic brow lift or lateral brow lift will give you nice results that will last several years.

Also please note that none of these methods addresses extra skin on the eyelids - that is only treated with blepharoplasty surgery.

Hope this was helpful for you!

Kamran Jafri, MD
New York Facial Plastic Surgeon

Botox or Thermage for Browlifting?

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As I have written in answering a related question, Botox injection just below the eyebrow can create a lifting of the brow by relaxing the muscles that normally pull or hold the brow down.  This so-called "chemical browlift" is most commonly used to lift the outer third of the brow but can be used along its entire length.  From an aesthetic perspective, the brow arch should peak between the middle and outer thirds.  This Botox effect will only last 4-5 months, whereas a surgical browlift should last many years.  Thermage works by tightening skin due to application of high energy waves.  Generally speaking, Thermage has been used more frequently in other areas of the body, not around the eyes or for browlifting, and I don't think the subtle skin tightening would withstand the normal downward muscular pull in that area.  My preference would be for either the Botox treatment or surgery, depending on your degree of brow sagging.

Richard G. Schwartz, MD
West Palm Beach Plastic Surgeon
5.0 out of 5 stars 32 reviews

Botox versus Thermage for Browlifting

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Obviously, Botox works far more effectively than Thermage. Thermage, which is quite a painful procedure, has a very limited efficacy and does not have a significant, demonstrative long term effect.

Rod J. Rohrich, MD
Dallas Plastic Surgeon

Botox and Thermage--totally different

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Wow--Botox and Thermage are totally different treatments.

Botox works by turning off the muscles that pull down the brow and cause wrinkles between the brows. By turning off the downward pull of the muscles, the brow elevator muscles work un-opposed and pull the brow up. The produces a "chemical" browlift.

Thermage lifts the brows more superficially by tightening the skin. This "shrinkage" allows the brow to elevate some.

Theda C. Kontis, MD
Baltimore Facial Plastic Surgeon
5.0 out of 5 stars 42 reviews

Endoscopic Browlift is Best for Raising the Brow

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An endoscopic browlift still represents the gold standard for raising the brow.  Patients frequently look for alternative to avoid surgical procedures.  Several alternatives exist when this scenario arises.  The botox browlift is effective but needs to be repeated at three to four month intervals.  Most surgeons, would agree that Thermage has a minimal impact on the brow, is painful and has significant expense.  For this reason, the botox browlift is a better alternative.

Botox browlift versus Themage for the eyelids

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 Botox is a muscular paralytic agent placed in the forehead expression muscles which decreases the vertical lines between the eyebrows and horizontal lines  in the  forehead on a  temporary basis. Thermage attempts to shrink wrap skin in the neck, and we have never seen that application in the forehead or eyelids work. A surgical browlift softens the expression of the corrugators, procerus, and frontalis muscles along with raising the eyebrows and adjusting asymmetry in the eyebrows as well.  The Forehead lift  can also adjust the hairline upwards or downwards depending upon placement of the incision. For many examples, please see the link below to our browlift photo  Gallery

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 157 reviews

Toronto Brow Lift

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I wouldn't recommend Thermage for the eyes. If you have a heavy or depressed brow then a Botox brow lift or formal surgical brow lift may be better options. See a board certified plastic surgeon in your area.


Asif Pirani, MD, FRCS(C)
Toronto Plastic Surgeon
5.0 out of 5 stars 35 reviews

Thermage® won’t give the same results as BOTOX®

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We offer both Thermage® and BOTOX® Cosmetic at my practice; these two procedures work very differently. Thermage® uses radiofrequency waves to trigger new collagen production while firming up loose skin. BOTOX®, on the other hand, temporarily paralyzes the muscles that cause dynamic wrinkles. In the brow area, using several injections can help relax the forehead and eye muscles enough to eliminate that fallen brow that so often shows up with age. This is sometimes called a chemical brow lift. Thermage® does not affect the muscles, which are the primary culprit when it comes to aging around the eyes and forehead. I would choose BOTOX® instead.

David N. Sayah, MD, FACS
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 10 reviews

Botox Browlift vs. Thermage

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For a non-surgical browlift, Botox is an excellent option.  Placing a small amount of Botox in the upper lateral orbicularis muscle (around the eye socket) can give a pleasing lift to the tail of the brow. Thermage, and other non-surgical tightening devices/treatments, have some utility in the lower face but not generally in the brow region. In addition, these treatments tend to be more expensive and don't work in all patients.

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.