[Lari Plastic Surgery] About the Effects of Forehead Botox on Eye Shape and Double Eyelid Line

If, when consulting for eye surgery, forehead Botox is recommended as needed,

there are often people who ask why they should get forehead Botox and say they are fine as they are.

People who are advised to get forehead Botox before eye surgery at a clinic

often use their forehead muscles to open their eyes rather than the eyes themselves, which is why they often have deep forehead wrinkles or eyebrows pulled far upward. They may not be aware of it, but when opening their eyes,

they do so this way naturally or out of habit.

So before eye surgery, it is better to minimize the use of the forehead muscles before proceeding with surgery.

Looking at the <23.4.14> photo above, you can see that the patient is opening their eyes fairly well. However, this patient was opening their eyes by using the forehead muscles so much that deep wrinkles formed on the forehead.

So after Botox was injected into the forehead, it became difficult to open the eyes properly using only one’s own strength, and the eyes became more than half smaller, as shown in the <23.4.20> photo.

At this stage, incision-based ptosis correction surgery was performed, and in the <23.7.19> photo, taken three months after surgery, the eyes are opening comfortably and widely. Compared with before surgery, the patient can now open their eyes more comfortably, larger, and more clearly,

and the eyes open well without using the forehead muscles.

The three photos were edited to match the same position, angle, and size. In the first photo, the eyebrows were cut off at the top of the frame, but in the lower photo, the eyebrows are fully within the frame. We can check whether the forehead muscles are being used by looking at the position of the eyebrows.

In the first photo we saw, the patient was at least using both sides of the forehead evenly, so there was the mistake of “opening the eyes with the forehead,” but there was no difference in how the two sides were opening.

However, in the photo above, you can clearly feel the difference between the two sides. In the <23.4.15> photo, you can see that the eye sizes on both sides are clearly different.

There can be various reasons for different eye sizes, but by looking at the eye size, shape, and eyebrows, we can tell that it was due to the use of the forehead muscles. Since the degree of forehead muscle use was different, the eye sizes were different and the eyebrow heights were also different, it is likely that the right forehead muscle (left side in the photo) was being used more.

So for this patient as well, we first aligned both eyes with preoperative forehead Botox. Because the degree of muscle use differed, Botox was not injected evenly across the forehead area, and a larger dose was injected into the right forehead (left side in the photo), which was used more, controlling the use of the forehead muscles.

Looking at the <23.4.22> photo, taken one week after the forehead Botox procedure, both eyes became the same, unlike before the Botox treatment.

In a similar context, this patient had undergone double eyelid removal surgery.

This was a patient who removed naturally formed double eyelids that had been thickly positioned, in order to make the eyes look wider horizontally. Even after nine months had passed after surgery, the left eye (right side in the photo) somehow looked larger than the opposite side, and the double eyelid line also seemed to show slightly, so the patient visited the clinic for a follow-up.

The cause here was also the use of the forehead muscles. The left eye (right side in the photo), which looked slightly larger in the <24.9.7> photo, showed the same changed appearance in the <24.9.20> photo, taken 13 days after the Botox procedure!

This shows that properly controlling the use of the forehead muscles and eyebrows can be an important point in eye surgery.

There is one more area where Botox plays a necessary role. That is when the eyes are opened too widely.

There are people whose eyes do not open well, but conversely, there are also cases where the eyes open well but, due to bad habits or mannerisms, the forehead muscles are used together with the eye-opening effort, causing the eyes to open somewhat too widely.

Looking at the <24.7.30> photo, the pupils are almost fully exposed upward, making the eyes look wide open. If surgery is performed immediately in this state, the habit of opening the eyes wide with forehead muscle use will continue even after surgery, and good results cannot be obtained. In such cases, as in the <24.8.6> photo, it is better to first control the excessively wide eye opening with forehead Botox and then proceed with eye surgery.

The conclusion that forehead Botox is needed is the same, but the process by which that conclusion is reached is the exact opposite of the cases above, right!?

Of course, excessively wide eye opening does not automatically improve just by getting forehead Botox.

For a patient like the one above, ptosis correction surgery should also be performed together in order to correct the excessive eye opening, but from the position of the eyebrows, we can tell that forehead Botox was needed here as well. Looking at the <24.2.13> photo, anyone can feel that the eyebrows are being lifted as much as possible using the forehead. Of course, these lifted eyebrows are also uneven, with the right side (left side in the photo) being raised much more.

In this case as well, ptosis correction and revision double eyelid surgery must be performed after making it impossible to use the forehead muscles. If the state were left as is, even if revision double eyelid surgery were performed to lower the line, the double eyelid line might still appear too large due to excessive use of the forehead muscles, and the symptom of eyes opening too widely might not be properly corrected. In the <24.2.29> photo, you can see that the eyebrows are much lower than in the <24.2.13> photo, and rather than simply making the excessively open eyes less open, we were able to remove the excessive appearance and recreate eyes that open clearly without feeling stuffy or lacking.

This patient underwent forehead Botox at the same time as surgery. Looking at the eyes before surgery, the eyebrows are uneven, with one side raised quite significantly, but in the photo taken five months after surgery, both eyebrows are nicely positioned in a seagull shape. Unlike before, when the eyebrows were uneven, the eyebrows were made symmetrical with forehead Botox, so the impression looks much cleaner and smarter. Thanks to the settled forehead, the double eyelid lines created by non-incisional double eyelid surgery have also taken shape in a balanced and attractive way.

In this way, the forehead and eyebrows in relation to the eyes are entities that cannot be separated. However, under unavoidable conditions, the muscles needed for different functions interact with each other, and bad habits can develop. If there is a useless habit in the way you normally open your eyes, auxiliary correction through forehead Botox may be necessary, and you should keep paying attention and work steadily to improve it along with the Botox.