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It's a week after my Botox, and I feel I am scowling all of the time as if I can't relax. Can this be fixed?

Thank you for sharing your photo. There are a few things that might have happened: 1) too many units placed centrally in the forehead resulting in an inability to lift the medial brows and causing heaviness; 2) not enough units placed laterally in the forehead which results in a hyperactive lateral brow. You can easily relax the arched brows with 1-2 units. Please follow up with your injector to determine whether you still have movement in the glabella (frown lines). If so, this muscle can be further relaxed to try to allow more lifting of the brow. If not, you will have to wait until the Botox wears off somewhat (can be a couple weeks to months) and the brows will start to return to baseline.

Clinical Context

Botox results can keep settling for one to two weeks after treatment, so an uneven or heavy brow at day seven may still improve on its own. The look depends on the balance between the central forehead muscle and the muscles lifting the outer brow. Adding more product too soon risks tipping that balance the other way. Your injector can check how much movement remains before deciding whether a small touch-up now makes sense or it's better to wait and reassess.

Answered By

Dr. Steven Williams

President Emeritus of ASPS

Dr. Steven Williams is a board-certified plastic and reconstructive surgeon, a diplomate of the American Board of Plastic Surgery, the Past President of the prestigious American Society of Plastic Surgeons, and a charitable person who dedicates his life to those in need of his unique expertise.

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