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Preventing Eye Ptosis from Botox?
I keep hearing more and more cases of eyelid ptosis or "droopy" or closed eye from Botox. Is there a way to decrease the chances of this happening? Does it happen as often with Dysport as well?
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21 Doctor Answers |
Asked by
KGB
+3
Eye ptosis from Botox is avoidable
Botox and Dysport are both great products and are often used in fact for brow elevation. Reasons for ptosis include:
1. poor injection techniques - getting too close to the eyebrow for example; one must know about anatomy of muscles and be able to recognize already exisiting asymmetries. None of us are perfectly symmetrical!
2. extreme dilution of the material - both come in a powder and are "reconsitituted" into an injectable solution; too much saline can dilute the product...
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Eyelid ptosis (drooping) is avoidable after Botox injections
How to avoid a droopy eyelid after Botox injections:
Go to a qualified experienced injector--incidence should be less than 1%
It turns out many people who end up with ptosis already have sub clinical ptosis. When the frontalis muscle is injected over aggressively to treat the horizontal forehead furrows, the ptosis can be unmasked. This is because the forehead muscle is compensating for the weakened eyelid muscle. Removing this compensatory muscle causes the eyelid to droop.
Injecting too...
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How to decrease the chances of Botox caused Eyelid and eyebrow drooping?
Your best way to prevent this from happening is to insist that your Botox treatments be done by a Board-certified Plastic Surgeon, ENT or Dermatologist NOT a subordinate "injector".
The brows are lifted by the forehead muscle (FRONTALIS) - when the muscle has to work too much (due to excess forehead skin), the muscles creases the forehead skin. Although some of these creases can be smoothed by weakening the underlying muscle, lacking the judgment and weakening the Frontalis just...
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Selecting your Botox injector carefully can help prevent problems
It is important to distinguish between Eyelid ptosis and Eyebrow ptosis.
Eyelid ptosis occurs when the eyelid excursion (ability to open and close) is diminished and the upper eyelid begins to cover the pupil, interfering with the upper visual field.
Eyebrow ptosis is when the eyebrow position is too low, and falls below the bony rim of the eye socket. This can make a patient appear as though the eyelid cannot open, when in fact there is nothing wrong with the eyelid muscles.
Both...
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Droopy Eyelids are Rare With Botox
In an experienced injector's hands, eyelid drooping is an extremely uncommon side effect. I always recommend treating only one area on the first visit and the glabellar complex would be the best place for you to start. I typically start with 20 units of Botox for this area unless the muscles appear to be fairly strong. This is a low-normal dose which, if properly place, has very little chance of causing eyelid drooping. It's always easier to add more if you don't get the desired...
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Honest answer about ptosis after botox
The honest answer is that it is a risk of the procedure. Plain and simple. If you have an inexperienced injector yes..it is more likely that they can place it in the wrong area and you get a droopy eyelid. However even the most experienced injectors have had patients with a droopy eyelid afterwards. It is one of the risks of the procedure..it goes away. There is not too much to be done to prevent it.
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Preventing droopy eyelid after Botox injection
"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...
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Quaz Rate Roughly Equal
Eyelid ptosis, or the dreaded quaz (named after Disney's version of Quisimodo), seems to occur at an equal rate between Botox and Dysport.
The Carruthers, (Alistair being the dermatologist and Jean, the ophthalmologist --the couple who first decsribed the cosmetic benefits of this amazing drug) looked at the incidence of eyelid ptosis on three occasions. The studies were performed in 2002, 2003, and 2005 with an occurance rate of 5.4%, 1%, and 0% respectively. Note, the diminishing...
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Eyebrow heaviness may be worse with Dysport since it spreads more than regular Botox
The advantage of Dysport over regular Botox is that it takes affect faster and may last longer and spreads a little more to cover more creases than regular Botox but that may also cause some more heaviness to the eyebrows for 2-3 weeks if it gets too close to the eyebrows. Neither should have much effect on the eyelids at all as far a drooping goes.
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Ptosis with Botox injection
Normally, to avoid ptosis of eyebrow, I will do a browlift when I am asked to perform forehead injections. Espcially when the injections are on outer part of foreheads.
Boulder Dermatologist
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Ptosis with Dysport or Botox
The chance of ptosis is related to how close the toxin is injected to the eye. So it is very easy to avoid by injecting far away from the eye. The problem is that the eyebrow furrow muscles are directly beneath the eyebrows. So if you want a really effective injection than you must inject the muscles directly and the risk for ptosis is increased. It really is a tradeoff. Dysport supposedly spreads more widely than Botox and the concern is that it could cause more potential for eyelid...
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Eyelid Ptosis after Botox
You say that you hear "more and more" about eyelid ptosis after Botox injections. This is because more and more people who are unqualified are injecting Botox. It is important that you go to a qualified injector and not just a spa or "Botox Party." However, even with the most experienced injectors, there is still a very small chance of ptosis. If this does happen, there are eyedrops which can help elevate the upper eyelid a few millimeters until the Botox wears off. ...
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Eyelid ptosis after BOTOX injections is uncommon.
BOTOX is effective at reducing glabella frown lines, and eyelid ptosis occurs in less than 1% of patients injected by myself. The few cases I've seen have been mild, and lasted no longer than 6 weeks.
Phenylepherine (OTC) or iopidine (prescription) eye drops are used to treat the ptosis until it wears off.
I hope this was helpful for you.
Best regards.
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Ptosis following BOTOX and Dysport are uncommon
Studies of BOTOX and Dysport initially suggested an incidence of upper eyelid ptosis of 3 to 5%. These are actually alarmingly high numbers. However in practice the actual incidence of upper eyelid ptosis is much less common. Andectodally the actual incidence is more like one or 2 per hundred treatments (1-2%). However, this does vary by injector. In my last 1000 BOTOX treatments there were no cases of upper eyelid ptosis. The take home lesson is the doctor you go to does make a...
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Eyelid ptosis is rare from Botox. Brow drooping is more common but can be predicted
True eyelid ptosis is when the upper eyelid muscle weakens and the eyelid comes down further on the pupil. This occurs very uncommonly. This is from Botox injected into the muscles around the eye socket diffusing into the upper eyelid.
What is more common is brow drooping or ptosis. This can be avoided or predicted in most patients. Treating the forehead lines relaxes the frontalis muscle that raises the forehead. Many patients already have overhanging eyelids or low eyebrows. They...
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An experienced doctor will prevent ptosis from Botox.
Hi!
Eyelid ptosis after Botox is not caused by the material. It can also happen with Dysport. Ptosis is caused only by bad technique. It is caused by injecting in the wrong place (too close to the upper eyelid). You need a plastic surgeon or a dermatologist who really knows the anatomy.
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Poor candidates or poor injectors
Sometimes, an inexperienced injector will inject the muscles in such a way that the brow elevator muscles are weakened and the brows drop. There are certain patients in whom this is a higher risk. An experienced injector will recognize them and avoid the injections that cause this to happen. True eyelid ptosis is very rare (where the lid levator is impaired). It is corrected with Iopidine.
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Preventing Eye Ptosis from Botox?
Ptosis after Botox injection is a complication that should be uncommon, but does occur. There are techniques to minimize the risk.. The cause of the ptosis is that the set of muscles that lifts the eyelid gets paralyzed from the Botox. Therefore, injecting away from that set of muscles is the key. Using a qualified physician to inject is essential. Ptosis can happen from Dysport as well.
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Drooping after Botox
It has nothing to do with the product and everything to do with the person doing the injections. As more and more unqualified persons do this injection, the more issues and complaints you will see.
So you need to make sure that you see a board certified plastic surgeon for you injectable needs.
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Eye Ptosis is Not Common With Botox or Dysport
It is a misconception that eyelid drooping (ptosis) is common. It is more of the brow ptosis. What happens is that your muscle of the forehead that pulls up your eyebrows is paralyzed to reduce forehead wrinkles. Since it can not lift up your brows, the droopy brows cover the upper eyelids and make it look like eyelids are droopy.
This can be avoided by either not injecting into the forehead muscle or trying to stay at least one inch above the eyebrow level.
The risks are the same for Botox...
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Preventing eye ptosis from Botox?
Best way is to be conservative with the amounts of Botox injected in the lateral portions of the eyebrow. And the experience of the Botox injector.
Does the brow or eyelid ptosis occur in my hands? Sure but very rarely, in about 1:350 patients. So, I try to be as careful and observant as possible.
Hope that helps!
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