Bad Eyelid Droop After Botox, Dr. Said It's Because of Fractured Skull, But I've Never Had An Injury... What's The Cause?

I just had 20 units above my brow now 1 eye is half closed. I look AWFUL & vision is compromised. The P surgeon gave me no post op advice, claiming there was none to give. I have since learned otherwise! He's blaming it on a fracture to my skull he claims I have, though I never had an injury. The over the counter drops aren't working. Will prescription drops work better? Could a fracture cause the Botox to travel? Or is it due to possibly rubbing my brow or sleeping after the treatment? Help :(

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6 Doctor Answers | Asked by One eye

Doctor Answers (6)
Community Comments (1)

WIth due respect to Dr. Nayak, the drooping can last much longer than 6 weeks.

You did not supply a photograph so I am presuming that you have developed actual upper eyelid ptosis where the eyelid margin blocks the pupil. It is also possible to have eyebrow ptosis where the eyelid margin position is normal but the eyebrows are very heavy. Brow ptosis does not look good but it is generally considered to a less serious problem. Upper eyelid ptosis after BOTOX occurs when the BOTOX injection results in the agent getting into the orbit and affecting the... more

Kenneth D. Steinsapir, MD

8 reviews

Los Angeles Oculoplastic Surgeon

Botox and eyelid droop

Excessive rubbing could cause the Botox to migrate and diminish eyelid muscle movement. Placing the Botox too close to the eyebrow can also allow the Botox to diffuse and cause the issue you relate. Fortunately the eyelid droop does not usually last as long as the normal treatment result would. Sorry to hear you had this happen.

Bad Eyelid Droop After Above Brow Botox

Without Before and After photographs it is impossible to make any comments specific to your situation. I have treated many people with Botox since 1997 and I have never heard of a silent, subclinical skull fracture nor of such a fracture causing botox to sip into the eye orbit. Furthermore, EVERY person getting Botox needs to be told what he / she cannot do. Among the don'ts is vigorous rubbing of the areas around the head toward the upper lid. Doing so may cause the botox to weaken the... more

Botox and eyelid droop

True eyelid droops are unrelated to drops of the eyebrows. The levator aponeurosis can be affected and may need prescription eyedrops, such as Iopidine, to help lift, to some degree, the eyelid. It will take up to four months to become normal.

Eyelid drooping after Botox

Drooping eyelids are very uncommon with Botox injection. But, sometimes Botox can migrate in the area from persistent rubbing just after treatment or poor injection technique. Eyedrops usually help to improve the condition. It will get better but may take a few months.

Steven Wallach, MD

12 reviews

Manhattan Plastic Surgeon

Eyelid droop after Botox

While eyelid droop after Botox is rare, it does occur. This occurs from Botox affecting the eyelid opening muscle. Most cases I have heard of do not involve any previous fracture. Pressing/rubbing on the area in the first 24 hours can cause the medicine to move, as can injection technique. The good news - it will mosty wear off by 6 weeks, and drops can help (as can additional Botox into the opposing eyelid muscles, although this is a VERY advanced technique).

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Comments (1)

One eye 11 Sep 2012

I just wanted to thank the drs that replied to my question. It did indeed take about 3 months for the droop to subside. It was a looooong and embarrassing 3 months. The problem was most severe the 1st month with no change. During the 2nd month there were some signs of improvement. As the 3rd month went on, it decreased til I looked just about normal. The condition still snuck up when i was tired at night. The eyelid was generally just "weak"

It is 7 months later and the issue is long gone. Though i do have some thin and shallow wrinkles on my forehead above that eye now. I believe it was from the strain of trying to over compensate and use the forehead to try and raise my eyelid. This was something i had noticed after the 1st week. The strain was starting to give me some tension headaches.....i later resorted to a patch for a period of time.

I hope my debacle serves as a warning for anyone looking into botox! Pick your dr carefully!

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