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Raise your sagging eyebrows with Botox brow lift

I often have patients come to see me at Clinica London who want to know how they can easily have their sagging brows raised medically rather than surgery, and without too much risk involved.
My answer is invariably the Botox brow lift. Brow lifting can be done surgically which is quite complex and has the potential for scarring, asymmetry and a dissatisfied patient. Brow surgery is quite invasive and involves local anaesthetic, cutting, suturing and the risk of a scar. Even if it is done endoscopically through small incisions in the forehead, it is not always a satisfactory result because the effect is not always sustained.
Therefore over the years, we have developed the Botox brow lift.
Using botulinum toxin has been a mainstay of my oculoplastic skills over the last 20 years. Botulinum toxin was first introduced for treating double vision into the eye muscles which move the eyes. After that, it was used for the eyelid, and facial spasm, particularly when there was a disease on the front of the eye called the cornea, and it was necessary to drop the upper eyelid. This was called a Botox protective ptosis.
We then got rather waylaid into thinking of Botox as being purely aesthetic. From about 1995 onwards, it has been used as an aesthetic treatment for eradicating horizontal lines in the glabella, getting rid of horizontal forehead lines, treating crow’s feet, etc. It is also extremely useful as a Botox brow lift.
The use of Botox in the periorbital area rejuvenates and opens up the eyes medically, instead of the requirement of surgery. Although it has to be repeated every three to four months, patients are very willing to come back and have this repeated treatment. It incidentally also gets rid of headaches and makes them feel a lot more relaxed. A winning situation.
Usually, when I do a Botox brow lift, I first assess the patient at the consultation. We spend about 20 to 30 minutes discussing what their concerns are and then examining them. We take photographic documentation. I examine all the muscles around the eyes looking at which ones close and which ones lift, which ones open and which ones depress. I then get a good idea of the individual strength of each muscle for that patient, and we look particularly for the asymmetries of the brow and low brows particularly laterally.
To lift the medial brow, I do glabellar injections, correcting against Mr Spock or Mephisto appearance by doing a couple of extra small injections on the upper outer forehead. Then to lift the lateral brow, I inject into the lateral orbicularis a little bit beyond the lateral eyebrow, so there is no risk to the eyelid of dropping (ptosis). This stops the strong eyebrow depressors, called the orbital orbicularis, from pulling the lateral brow down and allows the frontalis muscle to lift up the brows gently. If needed, I do then very tiny injections on the forehead and the crow’s feet adjusting my doses in each spot to maximise the muscles that we want to work and minimise the muscles that we want to work less.
If you are developing a brow ptosis and this is giving you headaches, making the eyelids feel heavy, it may well be that you do not require surgery, but you would benefit from a Botox brow lift.

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