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Botox Lower Eyebrows: Causes and Corrections

Medically Reviewed
Medically Reviewed by Dr. Aurora Kalmanson on
Written by Fillers Editorial Team, plastic surgery specialists.

When seeking to smooth out forehead wrinkles, Botox injections are a widely recognized solution. However, they come with the risk of accidentally lowering the eyebrows, leading to a droopy appearance that can affect facial expressions and even vision.

This condition, known as brow ptosis, is most commonly due to over-relaxation of the forehead’s frontalis muscle or improper injection techniques. While the effects are temporary, lasting about three to four months, there are ways to correct and prevent this undesirable outcome. Understanding the balance between the muscles involved in eyebrow positioning is key to achieving the desired aesthetic result without compromising natural expressions.

Causes of Droopy Eyebrows After Botox Treatment

Droopy eyebrows, or brow ptosis, can be a disappointing side effect of Botox injections aimed at reducing forehead wrinkles. It’s essential to understand the factors that contribute to this condition to avoid it and to seek appropriate correction if it occurs.

Improper Injection Technique

Injecting Too Much Botox or Too Low on the Forehead: The precise application of Botox is vital to avoid the unintended consequence of lowered eyebrows. An improper injection technique, such as administering too much Botox or placing injections too low on the forehead, can lead to the over-relaxation of the frontalis muscle. This muscle is primarily responsible for raising the eyebrows and maintaining their position. When it is excessively relaxed, the eyebrows can droop, creating a heavy or tired appearance.

Correcting Droopy Eyebrows Caused by Botox

Addressing the issue of droopy eyebrows following Botox injections involves a complex approach that may include additional treatments or corrective strategies.

Additional Botox Treatment

Consultation with a Board-Certified Plastic Surgeon: For individuals experiencing droopy eyebrows after Botox, a consultation with a board-certified plastic surgeon is a critical step towards correction. The surgeon’s expertise in facial anatomy and experience with Botox treatments are invaluable in determining the underlying cause of the droop. During the consultation, the surgeon will evaluate the patient’s facial structure, previous Botox treatments, and the current state of the eyebrows. This comprehensive assessment allows the surgeon to devise a personalized plan to address the droop, which may include additional Botox injections to rebalance the muscles or alternative treatments to support the eyebrows’ lift.

Eye Drops for Treating Droopy Eyelids

Prescription Medicated Eye Drops (e.g., Iopidine): Prescription medicated eye drops, such as Iopidine, can offer a temporary solution for droopy eyelids, a condition known as ptosis that may accompany eyebrow droop after Botox. These eye drops work by stimulating the Müller’s muscle in the upper eyelid, causing it to contract and lift the eyelid. This can alleviate the heaviness and improve the patient’s field of vision. While not a permanent fix, such eye drops can provide relief during the period until the effects of Botox naturally wear off.

Preventing Eyebrow Droop After Botox Injections

Preventing the undesirable effect of eyebrow droop after Botox injections is possible with the right approach and precautions. Key strategies include selecting a qualified practitioner and sticking to post-procedure guidelines.

Choosing a Licensed and Experienced Practitioner

Importance of Proper Training and Expertise: The importance of selecting a licensed and experienced practitioner for Botox injections cannot be overstated. Proper training and expertise are critical in ensuring that Botox is administered safely and effectively. A knowledgeable practitioner will understand the complex anatomy of the face and will be able to assess the appropriate injection sites and doses for each individual. They can also anticipate how the Botox will interact with the patient’s unique facial muscle structure, minimizing the risk of complications such as eyebrow droop. Additionally, a well-trained injector can provide comprehensive care, including managing any adverse reactions and offering sound advice for aftercare.

Following Post-Procedure Instructions

Avoiding Lying Down or Touching the Face: Following post-procedure instructions is crucial for achieving optimal Botox results and preventing complications such as eyebrow droop. One of the key recommendations is to avoid lying down or touching the face for several hours after the injections. This precaution helps prevent the Botox from migrating to unintended areas, which could affect muscle activity and lead to drooping. Patients should also be cautious when washing their face or applying makeup to avoid exerting pressure on the treated areas.

Frequently Asked Questions

How long does eyebrow droop from Botox usually last?

Eyebrow droop from Botox typically lasts until the neurotoxin wears off, which is usually around 3 to 4 months.

Is it possible to fix a dropped eyebrow caused by Botox?

Yes, a dropped eyebrow from Botox can often be corrected with additional treatments, such as strategic Botox injections or prescription eye drops.

Can dermal fillers be used as an alternative to Botox for eyebrow shaping?

Yes, dermal fillers can be used to shape the eyebrows by adding volume and altering contours, but they do not affect muscle activity like Botox.

How can I minimize the risk of drooping eyebrows when getting Botox?

To minimize the risk, choose an experienced injector, discuss your concerns beforehand, and follow all post-procedure instructions carefully.

How often should I get Botox injections to maintain my desired eyebrow position?

Botox injections are typically repeated every 3 to 4 months to maintain the desired eyebrow position, but this can vary based on individual response.

Conclusion

Botox treatments require a nuanced understanding of facial anatomy and a personalized approach to each patient. While Botox offers a dynamic solution for eyebrow shaping and wrinkle reduction, it is not without potential side effects, such as drooping eyebrows. By choosing a skilled practitioner, understanding the risks, and following aftercare instructions, patients can greatly enhance their Botox experience and enjoy a refreshed, youthful appearance.

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References:

Redaelli, A., & Forte, R. (2003). How to avoid brow ptosis after forehead treatment with botulinum toxin.

https://www.tandfonline.com/doi/abs/10.1080/14764170310023254

Angelo-Khattar M. (2020). A Novel OnabotulinumtoxinA Treatment Technique to Obtain Predictable Outcomes in Eyebrow Position and Shape.

https://www.dovepress.com/a-novel-onabotulinumtoxina-treatment-technique-to-obtain-predictable-o-peer-reviewed-fulltext-article-CCID

Jabbour, S. F., Awaida, C. J., ElKhoury, J. S., Rayess, Y. A., Makhoul, R. B., Kechichian, E. G., & Nasr, M. W. (2018). The Impact of Upper Face Botulinum Toxin Injections on Eyebrow Height and Forehead Lines: A Randomized Controlled Trial and an Algorithmic Approach to Forehead Injection.

https://journals.lww.com/plasreconsurg/abstract/2018/11000/the_impact_of_upper_face_botulinum_toxin.19.aspx

Dr. Aurora Kalmanson

Always Consult a Medical Specialist

The information provided in this blog is for informational and educational purposes only and should not be interpreted as personalized medical advice. It's crucial to understand that while we are medical professionals, the insights and advice we provide are based on general research and studies. They are not tailored to individual health needs or conditions. Thus, it is essential to consult directly with a healthcare provider who can offer personalized medical advice relevant to your specific situation.