Complete Superior Orbicularis Oculi Blockade With Botulinum Toxin for Eyebrow Repositioning: A Pilot Study

BACKGROUNDEyebrow position plays a critical role in facial aesthetics and aging. Botulinum toxin is widely used for facial modulation, yet the role of treating completely the superior portion of the orbicularis oculi muscle in eyebrow repositioning remains underexplored.

OBJECTIVETo evaluate the benefits, safety, and functional outcomes of botulinum toxin treatment in the superior portion of the orbicularis oculi muscle for eyebrow repositioning.

METHODSTen female participants with complaints of eyebrow dystopia were enrolled. Exclusion criteria included botulinum toxin treatment within the previous year. A standardized injection protocol with IncobotulinumtoxinA was applied, totaling 11 units per side. Patients were assessed with two-dimensional photographs before and 15 days after treatment, GAIS scores, pain scale, and self-administered questionnaires regarding adverse events and satisfaction.

RESULTSNine participants completed the study (mean age 32–61 years). At day 15, 89% reported improvement in eyebrow positioning (33.3% very much improved, 22.2% much improved, 33.3% improved), while 11.1% reported no change and none reported worsening. Mild pain was described by 77.8%, and 22.2% reported no pain. No significant adverse events, including eyelid ptosis or impaired lymphatic drainage, were observed. Overall satisfaction was 100%, and all participants indicated they would recommend the treatment.

CONCLUSIONIsolated but broader treatment of the superior orbicularis oculi muscle achieved satisfactory eyebrow elevation without increasing adverse events. This technique may serve as a promising adjunct to established botulinum toxin protocols for improved eyebrow positioning.

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