The practice of Botox injection is a combination of art and science. The science is fairly straightforward – Botox blocks the enzymes that cause muscles to contract, causing relaxation and smoothing of fine lines and wrinkles. Providers need to have a thorough knowledge of facial muscle anatomy and function of each muscle group. There are several small muscles that function to depress the eyebrows and these are the most commonly treated muscles to decrease those “11’s” between the eyes. There is only one muscle, called the frontal, that raises the eyebrows. This is also treated in order to smooth out the forehead. So one can conclude that injecting this muscle may reduce or prevent the ability to lift the brow.
A true eyelid droop, or ptosis, is very rare. This is a result of some of the Botox seeping into the upper eyelid and paralyzing the muscle that holds the eyelid up. One eye will appear to be completely closed. Again, this is very rare. It will usually resolve in 4 to 6 weeks. There are ways to treat this problem: eyedrops, which can help with eyelid drooping, or more Botox which can counteract the relaxed muscle. Again, this is an extremely rare complication.
More commonly, what appears to be an eyelid droop is a different phenomenon altogether. This has to do with the aging facial anatomy. The aging process effects the eyes in a unique way. As we age, the upper eyelid skin begins to sag and becomes folded over. Women often compensate for this by unconsciously raising their eyebrows when they look in the mirror. Injecting the forehead muscle will sometimes reduce or prevent the muscle from raising the eyebrows. What patients frequently confuse for a true ptosis is the inability to elevate the brow due to decreased function of the muscle. This has nothing to do with the eyelid muscle or poor injection technique. It is simple anatomy.
There are solutions to this. The patient can have cosmetic eyelid surgery, not treat the forehead muscle, or go to a provider that can customize the injection pattern to preserve the function of the muscle allowing some eyebrow lifting activity.
At Beautoxetc, we customize our treatments to fit your individual facial anatomy. Book an appointment today. www.beautoxetc.com