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Surprised Look After Botox

Posted: 6:00 a.m. Sunday, April 1, 2018

By Anita Mandal, M.D.
Question: I got botox for my forehead creases one week ago and now my brows look too high and arched. Can this be fixed or am I stuck with this look until the Botox wears off?

Answer: An overly arched brow, often known as the “Dr. Spock” brow can commonly be corrected. This look is not necessarily due to an error on the part of the injector. The forehead and brow muscles can be very complex in their connections. The lower forehead muscles meet the upper forehead muscles approximately half way up the forehead. While forehead injections are typically done in the upper half of the forehead, some patients can have highly variable forehead anatomy that cannot be foreseen by the injector. Medicine is not an exact science and there is no special “X-ray” to visualize the exact location or layout of your forehead muscles.

The good news is that fixing a “spock” brow typically involves just adding a little more botox to the outer part of the forehead to slightly lower a high-set brow and overly arched brow. The other good news is that once a Spock brow is fixed, your optimal injection pattern can be established so that the next time you get a treatment, your surgeon can use that optimal injection pattern to avoid a “spock” brow in the future.

What’s important is that your Botox touch-ups not be done sooner than two weeks. The reason is that your botox is still settling in during the first several weeks after injection and, in some cases, you may have an initial “spock” brow which normalizes on its own. Doing a touch up too soon can further distort your final result.

While seeking a skilled physician injector can certainly reduce your chances of getting a “spock” brow, no amount of skill will completely eliminate your chances of that risk, however low it may be. Recognizing and understanding that is a key part of being a realistic patient with realistic expectations. It’s equally important to be available with a flexible schedule between 2 and 3 weeks after your Initial Botox treatment just in case you need a touch up.


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