There are four likely causes of a droopy brow after Botox.
Brow droop can often be corrected right away with a little Botox in the right place – see 1 and 2 below.
The four likely causes and their treatment:
1. Inner brow droop? Treat with more Botox into the corrugator complex. These are the muscles between the brows that pull the inner brow down.
2. Outer brow droop? Treat with a little Botox into the lateral orbicularis muscle just under the brow. These muscle fibers pull the outer brow down.
3. The whole brow droops – the frontalis muscle was injected too low. You may need to wait for the effect to wear off – to avoid problem #4.
4. The upper lid droops over the pupil. This happens when the Botox is injected too low in the mid-brow, affecting the levator palpebrae, the lid lifting muscle. Iopidine eye drops may help by stimulating accessory lid-lifting muscles.
a. This is the most annoying Botox side effect and the reason that Botox is best placed about inch above the mid brow.
The best treatment is avoidance. If it happens, be sure your doctor adjusts the injection next time! And it helps to have your Botox done by a doctor who knows the anatomy. Best of luck!
Copyright May 2012 E Morgan MD