Temporal brow lift using botulinum toxin A

The objective of this study was to determine whether brow elevation occurs as a result of paralysis of brow depressors after botulinum toxin A injecti on. The study's design was a prospective case series with pretreatment and posttreatment outcome evaluation with statistical analysis at a university- based division of facial plastic surgery private clinic. Twenty-two patient s of a consecutive sample desiring a cosmetic enhancement underwent injecti on of botulinum toxin A directed to brow depressors. Injections consisted o f 7 to 10 units of botulinum toxin A (Botox, Allergan, Irvine, Calif.) into selected brow depressor muscle (lateral orbicularis oculi) bilaterally. No patients withdrew for adverse effects. All patients were evaluated 2 weeks after treatment. The outcomes were measured by change in brow elevation al ong vertical axis extending from both midpupil and lateral canthus to the c audal row of brow hairs with eyes at neutral gaze and the head at Frankfort plane. Preintervention and postintervention brow height was measured by th e primary clinical investigator. The average brow elevation from the midpup il observed after selected injection of brow depressors with botulinum toxi n A was 1.02 mm (p = 0.038). The average brow elevation from the lateral ca nthus observed after selected injection of brow depressors with botulinum t oxin A was 4.83 mm (p < 0.0001). Significant temporal brow elevation occurs as the result of paralysis of brow depressors by using botulinum toxin A i njection. This procedure may be considered an alternative to surgical brow elevation.