A botulinum toxin brow lift is an injection into specific muscles that pull the eyebrow downwards. Reducing their activity allows the brow to sit slightly higher and makes the upper eyelid area look more open. The effect works by rebalancing muscle pull rather than by tightening skin, and its size is a few millimetres, noticed in the look of the eyes more than measured with a ruler. It is usually requested by people who feel mild brow heaviness, slight brow descent, or minor asymmetry between the two brows, and by those who want a more open eye appearance without surgery. **Suitability is decided by clinical examination that assesses brow and eyelid movement, muscle strength and true eyelid ptosis, not by reading a web page.** The limits are explicit. Botulinum toxin **does not remove excess hooded skin over the eyelid**, which is a matter for surgical assessment, **and it does not correct true eyelid ptosis** caused by a weak levator muscle. It does not lift the brow to the degree surgery can, and it does not treat forehead heaviness from significant tissue descent. Anyone promising a clearly surgical-grade lift is promising what injection does not deliver. The result is **temporary**. The effect usually begins within a few days, settles over about two weeks, commonly lasts around three to four months, then fades gradually, and keeping it requires repeat injection. It is not given in pregnancy or breastfeeding, nor to people with neuromuscular disease, nor when there is active infection at the injection site, nor to anyone expecting a surgical outcome. **The most important practical step: verify that the facility is licensed and that the person injecting you is a licensed specialist physician, and ask to see the licence. Injecting around the eye by an unqualified person, in a salon or at home, is a genuine hazard, and misplacement here produces a drooping eyelid or an uneven brow that persists until the effect wears off.**
Procedure steps
- 1
Examination and assessing brow and eyelid movement
You are asked to raise and frown your brows and to close your eyes firmly so the physician can read how each muscle works, and to determine whether the heaviness comes from excess skin, from muscle activity, or from true eyelid ptosis. That distinction decides whether botulinum toxin is appropriate or whether surgical assessment is what you actually need.
- 2
Reviewing medical and medication history
The physician asks about any neuromuscular disease, medicines that may interact, pregnancy and breastfeeding, previous eyelid or eye surgery, **anticoagulants and bleeding disorders**, and any earlier injections and their outcome. A missing detail here produces an unwanted result that stays for months.
- 3
Planning and informed consent
Injection points are marked on your skin according to your anatomy, the achievable amount of lift is described honestly, and it is explained that the effect is temporary and may need adjustment after two weeks. Possible complications are covered: asymmetry, a heavy eyelid or brow, mild headache and bruising, and written consent is signed.
- 4
Disinfection and precise injection
The skin is disinfected, then the marked points are injected with a very fine needle at the correct muscular plane, keeping away from areas that could cause eyelid droop. The session is quick, you feel brief pinpricks, and small bumps may appear that settle within minutes.
- 5
Two-week review for assessment and refinement
The effect is reviewed after about two weeks once it has settled, checking symmetry and the amount of lift, and a small refinement can be made then if needed. Judging the result on the first or second day is far too early and leads to wrong decisions.
Before the procedure
Tell the physician about any **neuromuscular disease** and about all your medications and supplements, especially **anticoagulants, antiplatelet drugs and any clotting disorder**, and do not stop a prescribed medicine on your own. Say if you are pregnant, breastfeeding or planning pregnancy, because these injections are postponed. Mention any previous eyelid or eye surgery, existing eyelid droop, chronic dry eye, or an earlier injection you were unhappy with. Postpone the appointment if there is active infection, inflamed acne or a cold sore in the area. Avoid alcohol and non-essential painkillers beforehand to reduce bruising, and do not book within two weeks of an important event. **Ask to see the facility licence and the physician's name and specialty before starting.**
After the procedure
Stay upright for about four hours after the injection, do not rub or massage the area, avoid sauna, steam, strenuous exercise and prolonged bending on the first day, and skip heavy make-up for the first few hours. Mild redness, a small bruise and a light headache are expected. **Go to the emergency department immediately if you develop severe pain out of proportion, pallor, mottled skin discolouration, or any change in vision after the injection, as these signal a possible vascular occlusion.** **Contact your physician promptly for fever, pus discharge, or swelling that increases after some days, as these are signs of infection.** **Seek urgent care for difficulty swallowing, breathing or speaking, or generalised muscle weakness.** Also call the clinic for a drooping eyelid, double vision, or obvious asymmetry.
Expected duration
The injection session itself usually takes 10 to 20 minutes, with extra time for consultation and planning at the first visit. The effect typically begins within a few days and settles over about two weeks, and a review appointment is set for assessment and refinement. You can return to work straight away while avoiding strenuous exercise on the first day.
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