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Robert C. Langdon, MD

Guilford Dermatologist

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Recent answer posted by Robert C. Langdon, MD

Q: Preventing eye ptosis from Botox?

A:

"Droopy eyelid" after Botox or Dysport injection is the result of an inadvertent paralysis effect on the levator palpabrae muscle, a small muscle that serves to elevate the upper eyelid. This problem is very rare when experienced physicians administer the injection (the last time this happened in one of my patients was in 1999). It usually occurs after Botox injection in the frown line area (glabella). The levator palpabrae muscle is located somewhat deep below the surface of the lid; if a small amount of Botox diffuses in this area it may weaken the muscle. The key to avoiding this unwanted side effect is for the physician to keep any injections near the middle portion of the eyebrow at least a few millimeters above the brow.

If weakness of the levator muscle does occur, it can be alleviated by the use of eye drops (Apraclonidine) that stimulate another small muscle that can also lift the lid. The effect of the Botox will wear off after 3-4 months.

"Droopy eyelid" should not be confused with a sagging eyebrow, which can result if too much Botox is used in the forehead, weakening the muscle that lifts the brows (frontalis muscle).

Board certification
EducationMedical School:
University of Oregon Medical School, 1980
Post-medical school training Internship:
Good Samaritan Hospital, Internal Medicine, 1981

Residency:
Dermatology, Yale-New Haven Hospital, 1984
Aesthetic medicine experience 19 years (post-medical training)
Professional membershipsAmerican Society of Dermatologic Surgery (ASDS)
Hospital affiliations Yale-New Haven
Medical or professional licenseCT
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LocationThe Langdon Center for Laser and Cosmetic Surgery
5 Durham Road
Guilford, CT View map
Last modified 10 days ago