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Botox
Dr. says more Botox will make my lids droop, is this true? Her injections or lack of have caused a “Dr. Spock” brow.
Yes, more Botox can cause eyelid drooping, but it's about placement, not just quantity. Ptosis happens when Botox diffuses into the levator palpebrae superioris, the muscle that holds your upper lid up. This is more a function of injection technique, depth, and location than total units. The "Spock brow" look you're describing usually comes from an imbalance in the frontalis muscle: if the central and medial fibers are treated but the lateral fibers aren't (or are treated too lightly), the outer brow stays elevated relative to the rest, giving that peaked, arched appearance. The fix is usually a small, precisely placed dose in the lateral frontalis to relax that upward pull, not necessarily a larger overall dose. Without an exam, I can't say exactly how much you'd need, but this is a common and very treatable issue. Bring it up with your injector, and if she's hesitant, a second opinion from a board-certified plastic surgeon can help clarify the plan.
Clinical Context
Eyelid drooping and brow asymmetry after Botox both stem from how the toxin spreads and where it's placed, not simply how much is used. The frontalis muscle controls brow height, while a separate muscle, the levator, keeps the eyelid open; injecting near the eyelid muscle can cause temporary drooping, while uneven dosing across the forehead can cause an arched or 'Spock' brow. Both issues are usually correctable with careful, targeted re-treatment.
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