EXPLORE
Plastic Surgery
Dr. Barry Eppley

Explore the worlds of cosmetic
and plastic surgery with Indianapolis
Double Board-Certified Plastic
Surgeon Dr. Barry Eppley

Technical Strategies – Botox Injections for a Brow Lift Effect

 

One of the most common uses for the well known aesthetic drug, Botox, is injection into the forehead. While it is most commonly used to treat horizontal forehead lines and vertical glabellar rhytids, it is also used to create a chemical brow lift. While such injections can be very effective, it it not uncommon for some patients to develop adverse aesthetic effects such as brow asymmetry and even the opposite effect of brows getting lower rather than elevated.

Like all facial injections there is an art form to doing them. But it really based on an understanding of the anatomy of the muscles and how they work. Brow shape and position one the brow bone is because of an interactive relationship between the multiple inner and outer depressor muscles and the one main forehead elevator. (frontalis muscle) Thus to create a complete brow lift the inner and outer depressor muscles must be theoretically injected.

In the January 2018 issue of the journal Plastic and Reconstructive Surgery an article was published entitled ‘The Impact of Botulinum Toxin on Brow Height and Morphology: A Randomized Controlled Trial’. The authors evaluated the effects of injecting both inner and outer depressor muscles (Group 2) or just the lateral depressor muscles (Group 1)on brow height and shape. Fifteen patients (30 eyebrows) were done in each injected group with 25 units injected into the lateral depressors and 10 units into the medial depressors.

Their results showed that the brow was elevated up to 2mms across the entire brow in Group 1. In Group 2 the brows elevated up to 1.7mms in the outer half of the eyebrow with no change in its inner 1/3.

These study results initially seem counterintuitive. How could injecting both sides of the eyebrow result in electing only its outer portion? And how could just injecting the outer depressors result in more complete brow elevation? The authors hypothesis that there is diffusion of the drug into the lower frontalis muscle with injection into the medial depressors leading to partial deactivation. This results in no change in the medial brow position but increased resting tone of the frontal, raising the lateral brow.

These study findings provide guidance as to how to inject Botox for eyebrow elevation to meet patient expectations. For those seeking lateral brow elevation along, both the inner and outer depressors should be injected. But for those seeking total brow elevation only the lateral depressors should be injected.

Dr. Barry Eppley

Indianapolis, Indiana


Dr. Barry EppleyDr. Barry Eppley

Dr. Barry Eppley is an extensively trained plastic and cosmetic surgeon with more than 20 years of surgical experience. He is both a licensed physician and dentist as well as double board-certified in both Plastic and Reconstructive Surgery and Oral and Maxillofacial Surgery. This training allows him to perform the most complex surgical procedures from cosmetic changes to the face and body to craniofacial surgery. Dr. Eppley has made extensive contributions to plastic surgery starting with the development of several advanced surgical techniques. He is a revered author, lecturer and educator in the field of plastic and cosmetic surgery.

Read More


Free Plastic Surgery Consultation

*required fields


Military Discount

We offer discounts on plastic surgery to our United States Armed Forces.

Find Out Your Benefits


Categories