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Mimi S. Kokoska, MD; Jason B. Amato, MD; Christopher S. Hollenbeak, PhD; Dee Anna Glaser, MD

Arch Facial Plast Surg. 2002;4:244-247.

Objective  To determine if clinically used botulinum exotoxin A (Botox) injections to the forehead and glabellar and crow's-feet regions result in modifications of eyebrow position.

Design  Prospective study.

Setting  Academic medical center in St Louis, Mo.

Subjects  Twenty-nine adult patients treated with botulinum exotoxin A injections for rhytids.

Intervention  The eyebrow position at 13 different sites was measured before injection and 2 weeks after treatment. The areas injected were based on patient preference and physician assessment. Of the 29 patients, 14 received injections into the glabella only and 15 received injections into the glabella and forehead, with or without treatment of the crow's-feet.

Results  In 29 patients at rest, we found no significant (P value range, .17 to .97) change in eyebrow position, except for a point depression at the right lateral eyebrow. The 15 patients who received injections into the forehead and glabella, with or without treatment of the crow's-feet, had no significant (P value range, .11 to .84) change in eyebrow position, except for a point of depression at the left medial eyebrow. Both groups exhibited eyebrow depression in the active state (eyebrow maximally elevated).

Conclusions  Botulinum exotoxin A injections into the forehead and glabellar, and crow's-feet regions did not significantly change the resting eyebrow position. However, forehead injections contributed to eyebrow depression in the active state.

From the Department of Otolaryngology–Head and Neck Surgery, Indiana University School of Medicine, Indianapolis (Dr Kokoska); the Department of Dermatology, Saint Louis University Health Sciences Center, St Louis, Mo (Drs Amato and Glaser); and the Department of Surgery, Graduate Health Administration Program, The Pennsylvania State University–College of Medicine, Hershey, Pa (Dr Hollenbeak).

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