Rochester Botox doctors

Brett S. Kotlus, MD Brett S. Kotlus, MD
Rochester Oculoplastic Surgeon
8180 26 Mile Rd Suite 300, Shelby Township
6 answers
Myra Danish, MD Myra Danish, MD
Rochester Facial Plastic Surgeon
4550 Investment Drive Suite 290, Troy
Richard Hainer Richard Hainer
Rochester Plastic Surgeon
441 S Livernois Rd Ste 260, Rochester
Joseph E. Mark, MD Joseph E. Mark, MD
Rochester Plastic Surgeon
1886 W Auburn Rd Suite 200, Rochester Hills
David Roger Byrd, MD David Roger Byrd, MD
Rochester Dermatologist
Rochester

Recent Answers

Is 45 Units of Botox Too Much?

I have always gotten 10 units on my forehead. although it didnt remove every line it looked smooth when my muscle was relaxed & lasted 3 months. i went 2 a new doctor becaue mine is out of town for 3 weeks and he insisted on 45 units! I'm only 26. there's only two small lines 2-3inches long that show up with no muscle movement? Is this outrageous amount?

A: Botox Units

How  much Botox someone needs to acheive a good result is based on the size of the muscles being treated and the experience of the doctor to determine how many units will relax those muscles. The number of units is a universal way of describing the strength of your treatment regardless of the way in which it is diluted.

Treating the forehead without treating the "11" area (glabella) can cause droopy or heavy brows, because once the forehead muscles are weakened, there is nothing left to hold the brows up.  This may be why the new doctor suggested more units to the glabella.  It is not unusual to treat the glabella with 20-30 units and to treat the forehead with 6-12 units. 

Brett S. Kotlus, MD
Rochester Oculoplastic Surgeon
What is the Right Dosege for Lopidine for Botox-caused Drooping? I got Botox on April 29, 70 units from crow feet to cf. Six days later I noticed my right eye drooped. The doctor prescribe Lopidine one drop morning and one night. I used for 2 days no improvement, so I increase the dosage 2 drops am, 1 at noon and 2 pm. It been 7 days and I only feel improvment when I put the drops and then it wears off. Could I overdose and make it worse. Very depressing :(( When will I see results?
A: Iopidine to help with eyelid droop after Botox

Iopidine 0.5% can help to improve eyelid drooping (blepharoptosis) induced by botulinum toxin A (Botox). It works by stimulating one of the muscles that lifts the eyelid (Mueller's muscle).  This medication can raise the eyelid several millimeters and it can last for a few hours.  Using Iopidine in this manner is considered an "off-label" use, meaning it is not approved by the FDA. The most common dosing is 1 or 2 drops at a time, either several times a day or just before social events. It should not really be used more than 3 times a day. 

Luckily, a droopy eyelid after Botox resolves within weeks and rarely months.

Brett S. Kotlus, MD
Rochester Oculoplastic Surgeon
Eye Infection from Botox Eye Droop?

I had Botox done around last month, and I experienced drooping in one eye. I used drops to deal with the drooping, and somehow, my eye got infected. Does the infection have anything to do with Botox or the eye drops?

A: Drops to counteract botox-induced eyelid droop

Eyelid drooping (blepharoptosis) is an exceedingly rare result of botox injections. This complication is highly related to the injection technique and placement. Droop of the upper eyelid does not cause dryness or infection, in fact it makes the surface of the eye less dry. The clearance of tears from the eyes is not related to the muscle that causes eyelid droop (levator palbeprae muscle) but it is related to the eyelid closing muscle (orbicularis oculi) which can be affected if you had botox injected directly into the eyelid. Luckily, droopy lids always resolve when caused by botox, and this can take 6-12 weeks on average.

There are several eye drops commonly prescribed to counteract eyelid droop after botox. These include Apraclonidine (Iopidine), Bromonidine, and neosynephrine. These are prescribed by a physician. Any of these drops can cause a conjunctivitis by stimulating allergy or irritation.

However, eye infections or conjunctivitis can occur at any time, unrelated to other conditions. Examination by your doctor, or an ophthalmologist is warranted.

Brett S. Kotlus, MD
Rochester Oculoplastic Surgeon
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