The Neurotoxin Spock Brow Phenomenon and How to Avoid It

A few Thanksgivings ago, my mom showed up with an eyebrow that can only be described as akin to the face that Dwayne Johnson makes when asking, “Can you smell what The Rock is cooking?” Her right brow was arched like she was questioning everything, while the other brow remained at ease. The culprit? Mismanaged neurotoxin injections at a medspa. This phenomenon is fairly common, especially when getting injected by people that aren’t board-certified doctors, and is often referred to as “Spock brow.” We asked the experts how this happens, how to prevent it and how to fix it if it’s already too late.

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What Is Spock Brow?

“Spock brow is when the outer portion of the eyebrow lifts higher than intended after neuromodulator treatment, creating an arched or peaked look,” explains Chapel Hill, NC dermatologist Sue Ellen Cox, MD. West Palm Beach, FL dermatologist Kenneth Beer, MD notes that the name comes from the quizzical appearance of Spock on Star Trek, thanks to his highly arched eyebrow tails.

How Does Spock Brow Happen?

The unnatural looking brow typically results when not enough attention is paid to the lateral aspects of the forehead muscle, says Houston dermatologist Jennifer Segal, MD. It can happen “when the central forehead muscles receive a stronger dose while the lateral frontalis is under-treated, allowing the outer brow to lift more than the center,” explains Dr. Cox.

How Long Does it Take for the Eyebrow to Return to Normal?

There’s no way to accelerate the wear off of neuromodulators, and most patients begin to regain movement around two to three months post-treatment, with a full return to baseline closer to four months, says Dr. Cox. However, Dr. Beer says a Spock brow can usually be easily treated with a small amount of neurotoxin placed above the highest portion of the brow.

“If the brow is excessively elevated, a small corrective dose to the lateral frontalis can relax the overactive area and rebalance the brow position,” says Dr. Segal. She notes that during this correction, “Attention must be taken so that this does not create a heavy or dropped brow.”

How to Avoid Spock Brow

It’s all about injector technique, so it’s crucial to seek a board-certified expert injector. “It’s important to work with a physician injector who understands forehead anatomy and tailors dosing across the frontalis to maintain even brow support,” says Dr. Cox. “Careful placement and balanced dosing are the key to preventing this outcome.”

Even with a skilled injector, it can sometimes be challenging to avoid this outcome. Dr. Beer says the best way to do it is to start small. “Small amounts of neurotoxin in the frown (glabella) and lateral forehead (frontalis) can soften lines and shape the brow in a natural appearing way,” says Dr. Segal.