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One eyebrow raising much higher than the other after Botox. Is this normal?

While it's difficult to say without photos, it sounds like you may have some residual muscle activity at the lateral brow. One of two things may be happening: 1) Botox takes 2 weeks for the full effect. The "spock brow" may continue to resolve on its own with time but scenario is less likely as one brow is not moving and the other is, suggesting that one brow elevator is either under-treated or you have a hyperactive muscle on that side. The spock brow most likely will not get worse with time- it just won't get better. I would encourage you to follow up with your injector at 2 weeks to reevaluate. 2) Your injector did not treat laterally enough on one side of the forehead (the side with spock brow). This is an easy fix and typically only requires 1-2U to relax the frontalis muscle for better symmetry on animation.

Clinical Context

This kind of unevenness usually hinges on how your frontalis muscle was working before treatment, not on anything going wrong with the injection itself. Most people have some natural asymmetry between sides, and one eyebrow often sits or moves higher normally. Once Botox relaxes the treated areas, that pre-existing imbalance can become more noticeable because the weaker side has less lift to compete with. It typically evens out with a small touch-up once results fully settle, usually around two weeks.

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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