How to Fix The Spock Brow and Brow Droop

Many fear the dreaded spock brow that can occur with neuromodulators. This video, Dr. Rajani discusses the spock brow and what can be done to prevent and correct it.

The spock brow typically occurs from neuromodulator use from products such as Botox, Dysport, Xeomin and Jeuveau. A spock brow results when the central forehead is weakened and the outer sides of the forehead are active, causing the central brow to drop and the outer brow to lift too high in comparison. In general for many injectors, the spock brow happens because they were “being safe” – meaning an injector would typically inject an area that would not cause a dropped brow. A heavy brow can be adjusted by injecting the orbicular part of the orbicularis oculi muscle and by also avoiding injections at the levator palpebral muscle which can lead to lid droop.

Understanding anatomy and vectors is important when trying to prevent or adjust a spock brow. Injecting the forehead above the lateral brow can create brow droop as Dr. Rajani reviews in the vector diagrams. The equidistant point from the nasal ala to the medial canthus provides a zone that creates a triangle in the forehead region and if injected, can potentially cause lowering of the brow. Here are some problems:

1. Injecting this danger zone can be performed if needed. If injections are needed in that region, the sprinkling method of micro doses of Botox can be done.

2. The temporal crest is typically where the frontalis muscle stops but can also go laterally. This leads to the muscle not being in an area where it usually is. This anatomical variation can lead to a spock brow if it was not injected.

The forehead is one of the most challenging areas to inject. Fortunately the spock brow can be corrected. Each patient has different goals and needs as well as anatomy and variations. By using the vectors and having a great understanding of anatomy, the spock brow can be avoided.

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