What is eyebrow botulinum toxin?
Eyebrow botulinum toxin is a procedure directed at the appearance of the vertical lines between the eyebrows. Whether any change in appearance is possible is assessed at the examination.
The substance used in this procedure, which is popularly known by a brand name, is botulinum toxin. Botulinum toxin is a prescription-only medicinal product for human use (opens in a new tab) that temporarily reduces the contraction of the muscle into which it is administered. The procedure is carried out with an authorised product, within the terms of use in its authorisation, and by a physician.
The procedure is performed at the practice (opens in a new tab) by Dr. Suzan Alp, Specialist in Internal Medicine.
Which factors determine whether the procedure is suitable?
The decision on suitability is made at the end of the examination. The following factors are decisive in the assessment of this area:
- Whether the lines appear with movement, or whether they also remain when the face is at rest
- How marked the habit of frowning is, and the strength of the muscle between the eyebrows
- Whether there is sagging or drooping of the eyelid
- Eyebrow position and the symmetry between the two eyebrows
- Any previous procedures in the area: in particular dermal filler
If dermal filler has previously been administered to this area, this must be stated during the consultation; the planning and the timing differ.
In which patients is the procedure not performed?
- In patients with a disease affecting the neuromuscular junction (myasthenia gravis, Lambert-Eaton syndrome, amyotrophic lateral sclerosis and similar conditions)
- In pregnant and breastfeeding patients
- In patients under 18 years of age
- In patients with a history of allergy to the product to be used or to its components
Situations that require separate assessment
- Muscle disease (an assessment by the relevant specialist physician is required)
- Use of medicines that affect neuromuscular transmission (aminoglycoside antibiotics, muscle relaxants and similar)
- Bleeding or clotting disorder, or use of blood-thinning or anticoagulant medicines
- Active infection or febrile illness (the procedure is postponed)
- A recent procedure in the same area (the timing is adjusted accordingly)
Additional conditions specific to this area
The procedure is not performed if the following are present in the area to be treated:
- Active infection, an acne lesion or an open wound
In these situations, the procedure is planned subject to the physician’s assessment:
- Eyelid drooping (in this area the procedure may make it more pronounced)
- Marked excess skin on the upper eyelid
- Previously applied dermal filler in the area (timing and planning are adjusted accordingly)
- Marked eyebrow asymmetry (the possibility that it may increase after the procedure is discussed beforehand)
How is the procedure performed?
- Assessment. The strength of the muscles between the eyebrows, the type of lines, the condition of the eyelid and eyebrow symmetry are assessed. You are asked about any history of neuromuscular disease, current medication, allergies and previous procedures, including any dermal filler administered to the area. Blood pressure and pulse are measured.
- Product check. The authorisation status of the product to be used and its compliance with storage conditions are checked.
- Information and consent. The procedure, the temporary nature of the effect, the possibility of eyelid drooping, and possible side effects are explained in writing and verbally; a form is signed.
- Preparation. There must be no make-up on the area. Antisepsis is ensured.
- Administration. The product is administered at the predetermined points with a fine needle.
- Observation and follow-up. Vital signs and any observed findings are recorded in the file. A follow-up appointment is given, at which the outcome will be assessed.
When does the effect begin, and how long does it last?
The time it takes for the effect to appear varies from person to person; the full result is assessed between a few days and two weeks. The effect is temporary, and how long it will last cannot be stated in advance. The timing of any repeat is determined at the follow-up.
What should you do before and after the procedure?
Before the procedure, report:
- A list of all the medicines and supplements you use (in particular blood thinners, painkillers and antibiotics)
- Your known allergies
- Any history of nerve or muscle disease
- Your pregnancy and breastfeeding status
If dermal filler has previously been administered to this area, please state this.
Come with no make-up on the area.
After:
- The area must not be massaged or rubbed on the day of the procedure
- You are asked to avoid bending forward and keeping the head down for long periods for the period specified (this is particularly important for the area between the eyebrows)
- You are advised to avoid lying face down for a period
- Avoid hot environments, saunas, sunbeds and intense exercise for a period
- Temporary raised bumps, redness and slight bruising may occur at the points of administration
Recommendations and periods specific to you are given in writing at the end of the procedure.
Risks and side effects
Risks specific to this area
- Eyelid drooping (an unwanted outcome that requires attention in the area between the eyebrows)
- Eyebrow asymmetry
- A change in eyebrow position; a greater lift than expected at the outer part of the eyebrows
- Temporary headache in the area
- A greater reduction than expected in the frowning movement
General risks that may occur with any minor procedure
- Pain, redness, swelling and bruising
- Infection at the site of the procedure
- A change in facial expression
- Allergic reaction
- Flu-like symptoms
- Vasovagal syncope (fainting)
These side effects are temporary; however, the time they take to resolve varies from person to person and may last weeks. It is not possible to reverse the effect of the botulinum toxin.
Results vary from person to person.
When should you see a physician without delay?
If you experience these symptoms during treatment, contact your physician without delay:
- Drooping of the eyelid, or a change in vision
- Increasing redness, increased warmth, swelling or discharge at the site of the procedure
- Marked bruising in the area
- A high fever
- Widespread rash, itching
In the event of difficulty swallowing, disturbance of speech, double vision, shortness of breath, widespread muscle weakness, swelling of the lips or eyelids, or blanching or severe pain in the area, go directly to the emergency department.
Frequently asked questions
Are eyebrow botulinum toxin and eyebrow lift botulinum toxin the same thing?
No. Eyebrow botulinum toxin concerns the appearance of the vertical lines between the eyebrows. An eyebrow lift, on the other hand, aims to raise the position of the eyebrows, and different points are assessed; Eyebrow Lift Botulinum Toxin is described on a separate page.
Will my eyelid droop after eyebrow botulinum toxin?
Eyelid drooping is the unwanted outcome that requires the most attention in this area. For this reason the condition of the eyelid is assessed before the procedure, and you are asked to follow the advice given about bending forward, massage and rubbing after the procedure.
I have previously had dermal filler between my eyebrows; can botulinum toxin be administered?
This information must be stated during the consultation. In those who have previously had dermal filler in the area, the planning and the timing are assessed separately.
Will I be unable to frown after eyebrow botulinum toxin?
A greater reduction than expected in the frowning movement is among the reported side effects. The aim is not for the movement to disappear altogether; however, the result varies from person to person, and this possibility is discussed before the procedure.
The line between my eyebrows remains when my face is at rest; will botulinum toxin be enough?
Lines that appear only with facial movement and lines that remain when the face is at rest are not assessed in the same way. In the second situation, the contribution expected from this procedure is limited; which of the two applies is determined at the examination.
How long does the effect of eyebrow botulinum toxin last?
The effect is temporary and its duration cannot be stated in advance. It varies according to the person, muscle strength and the pattern of application. The timing of any repeat is determined at the follow-up consultation.
Is eyebrow botulinum toxin carried out during pregnancy?
No. The procedure is not carried out during pregnancy or breastfeeding.
Sources
- Ministry of Health of the Republic of Türkiye, Turkish Medicines and Medical Devices Agency, Beşeri Tıbbi Ürünler Ruhsatlandırma Yönetmeliği, Official Gazette 11 December 2021 / 31686. https://www.resmigazete.gov.tr/eskiler/2021/12/20211211-5.htm (opens in a new tab)
- Ministry of Health of the Republic of Türkiye, Ayakta Teşhis ve Tedavi Yapılan Özel Sağlık Kuruluşları Hakkında Yönetmelikte Değişiklik Yapılmasına Dair Yönetmelik, Official Gazette 7 January 2025 / 32775. https://www.resmigazete.gov.tr/eskiler/2025/01/20250107-3.htm (opens in a new tab)
