What is eyebrow lift botulinum toxin?
Eyebrow lift botulinum toxin is a procedure based on temporarily reducing the movement of the muscles that pull the eyebrow downwards. Whether a change in eyebrow position can occur 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 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.
This procedure is not the equivalent of a surgical procedure. No substance is administered that lifts the eyebrow; only the movement of the muscles that pull the eyebrow downwards is reduced, and whether or not this is reflected in eyebrow position is then assessed. The expected change is limited and may not be seen in every person.
If there is genuine sagging of the eyelid, this procedure does not address it; an assessment by the relevant surgical specialty is required.
This procedure is planned together with Forehead Botulinum Toxin and Eyebrow Botulinum Toxin; the forehead muscle is the one that holds the eyebrows up, and these three areas balance one another.
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 determine the assessment in this area:
- Eyebrow position and symmetry between the two eyebrows
- Whether there is sagging, excess skin or drooping of the eyelid
- Whether the eyebrow drooping is muscular in origin or is due to excess skin
- The strength of the forehead muscle and the habit of raising the eyebrows
- Any previous procedures in the area
If there is existing asymmetry between the two eyebrows, the possibility that the asymmetry may increase after this procedure is discussed beforehand.
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 or an open wound
In these situations, the procedure is planned subject to the physician’s assessment:
- Eyelid drooping (the opinion of the relevant specialist is sought)
- Marked excess skin on the upper eyelid (the expected contribution is limited; an assessment by the relevant specialty may be required)
- A field of vision kept open by raising the eyebrows
- Marked eyebrow asymmetry (the possibility that it may increase is discussed beforehand)
- Previous eye surgery or a surgical intervention to the eyebrow area (the opinion of the relevant specialist is sought)
- Previously applied dermal filler in the area (timing and planning are adjusted accordingly)
If the eyebrow drooping is not muscular in origin, this procedure does not address it.
How is the procedure performed?
- Assessment. Eyebrow position, eyebrow symmetry and the condition of the eyelid are assessed; whether the eyebrow drooping is muscular in origin is determined. The strength of the forehead muscle and the habit of raising the eyebrows are observed. Any history of eye surgery or neuromuscular disease, current medication, allergies and previous procedures are recorded. 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 limit of the expected change and the fact that this is not the equivalent of a surgical procedure, the temporary nature of the effect, the possibility of asymmetry and of drooping of the eyelid and the possible side effects are explained in writing and verbally; the form is signed.
- Preparation. There must be no make-up on the area. Antisepsis is ensured.
- Administration. The product is administered to the predetermined points with a fine needle. It is planned together with the forehead and the area between the eyebrows.
- 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 outcome 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 you have drooping of the eyelid, narrowing of your field of vision or a history of eye surgery, 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
- Bending forward and remaining head-down for long periods should be avoided for the period specified
- Lying face down should be avoided for a while
- Avoid hot environments, saunas, sunbeds and intense exercise for a while
- Temporary raised bumps, redness and slight bruising may occur at the points of administration
Advice and time periods specific to you are given in writing at the end of the procedure.
Risks and side effects
Risks specific to this area
- Eyebrow asymmetry (an unwanted outcome frequently reported in eyebrow lift botulinum toxin)
- Greater-than-expected elevation of the outer part of the eyebrow, and a change in eyebrow shape
- Drooping of the eyelid
- The eyebrow moving downwards, contrary to what was expected
- The expected change not being seen (the outcome in the eyebrow area is limited)
- A feeling of heaviness or tightness in the forehead
General risks that may occur with any minor procedure
- Pain, redness, swelling and bruising
- Infection at the site of the procedure
- Headache
- 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 take 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
- Marked eyebrow asymmetry
- Increasing redness, increased warmth, swelling or discharge at the site of the procedure
- A high fever
- Widespread rash, itching
In the event of difficulty swallowing, disturbance of speech, double vision, shortness of breath, widespread muscle weakness, or swelling of the lips or eyelids, go directly to the emergency department.
Frequently asked questions
Does eyebrow lift botulinum toxin replace surgery?
No. This procedure is not the equivalent of a surgical procedure. No substance is administered that lifts the eyebrow; only the movement of the muscles that pull the eyebrow downwards is reduced. The expected change is limited and may not be seen in every person.
My eyelid is sagging; would eyebrow lift botulinum toxin be a solution?
If there is genuine sagging of the eyelid, this procedure does not address it; an assessment by the relevant surgical specialty is required. The expected contribution is also limited in those with marked excess skin on the upper eyelid.
Can my eyebrows become asymmetrical after eyebrow lift botulinum toxin?
Eyebrow asymmetry is the most frequently reported unwanted outcome in this area. If asymmetry already exists, the possibility that it may increase after the procedure is discussed beforehand.
What happens if the outer part of my eyebrows rises too much?
Greater-than-expected elevation of the outer part of the eyebrow and a change in eyebrow shape are among the reported side effects. This is assessed at the follow-up consultation; it is not possible to reverse the effect, and it is expected to diminish over time.
What is the difference between eyebrow lift botulinum toxin and eyebrow botulinum toxin?
Eyebrow botulinum toxin concerns the appearance of the vertical lines between the eyebrows; the details are on the Eyebrow Botulinum Toxin page. Eyebrow lift botulinum toxin, by contrast, assesses whether or not eyebrow position will change.
How long does the effect of eyebrow lift botulinum toxin last?
The effect is temporary and its duration cannot be stated in advance. It varies with the person, muscle strength and the pattern of administration. The timing of any repeat is determined at the follow-up consultation.
Is eyebrow lift 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)
