Drooping Eyelids

Too much Botox into the obicularis oculi muscle can cause drooping eyelids and raised eyebrows several ways.   The raised eyebrows are due to frontalis compensating of the eyelid ptosis and paralysis of the obicularis side of the antagonistic muscle pair. 

If you did not have preexisting compensated eyelid ptosis, your eyelid ptosis is probably due to botox paralysis of the levator palpebrae.  Additional eyelid ptosis is probably due to the inability of the frontalis to fully compenstate through a flaccid obicularis muscle.

The 0.5% apraclonidine drops can partially help (~2 mm elevation) by contracting the Mueller muscle inside the eyelid.  Unfortunately, it takes more than 4 weeks for the significant improvements you are looking for.

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It seems that some of the Botox injected went into the upper eyelid orbicularis muscle and this caused the lid drop (ptosis).

The eyebrow elevation is from weakness of the depressors of the brow, so the frontalis muscle (elevator) took over. This could be a desired effect, however if excessive, it could lead to an unattractive look.

To fix this:

1. Few units of Botox above the eyebrow will weaken the frontalis and will drop the brow.
2. Alpha blocker drops will help to some extent with a moderate eyelid elevation.
3. Wait! It will go away.

Good luck

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