Can Dysport Result in Permanent Damage to Orbital Septum?

asked 4 months ago by Regrets366 in NSW, 02
Latest answer by Alan Engler, MD
Question viewed 191 times
Tags: crows feet, 6 months post-op, damage, fat pads, septum

Had dysport for crows feet 27 wks ago. Included injections towards the middle under my eye. Overnight a bulge under left eye developed which Dr thought was swelling from injection. It did not resolve & I now know it is a herniated orbital fat pad. As muscle activity has returned I have noted that when I smile widely the fat pad is pulled back into place. However when my face is relaxed or smiling slightly the bulge remains. Is it the muscles or septum that support the fat pad in a relaxed face?

7 answers to Can Dysport Result in Permanent Damage to Orbital Septum?

Dysport

Injection in the middle of the orbicularis muscle of the lower lid can cause some fibers of the muscle to become inactive while others are active causing dysharmony with animation (smiling) Injury to the orbital septum resulting in herniated orbital fat is possible that the needle ounctures the orbital septum , it would be unusual but that depend how experienced the injector is. Once you are fully sure that the effect of Dysport is completely gone, you will need a full evaluation by... more

Samir Shureih, MD
Baltimore Plastic Surgeon

Dysport - Permanent Damage

I am unaware of any reports of permanent damage being caused by the injection of Dysport or any other neurotoxins. It is important to distinguish between the chemical mechanisms (ie, the way the Dysport interferes with muscle contraction) and details of the injection itself (an injection, of any kind, involves using a needle to go across the skin barrier). While the chemical results are uniformly temporary (and may explain the muscle weakness causing your herniated fat to be more... more

Alan Engler, MD
New York Plastic Surgeon

Swelling after Dsyport injections

I do agree that what you have might well be herniated fat pockets but it would be very difficult for the needle used to inject Dysport to cause enough tearing of the orbital septum to cause that to happen.

Julio Garcia, MD
Las Vegas Plastic Surgeon

Festoons are possible

In addition to what has already been proposed, one common problem following the injection of botulinum toxin can be the formation of festoons or fluid pockets underneath the eyelid. The normal muscle tension of the orbicularis muscle may hide this tendency under normal circumstances. However with the loss of tone, any skin or muscle laxity is likely to reveal itself and may result in the formation of festoons. On a positive note, your condition should self-resolve as the toxin wears off... more

Ebby Elahi, M.D.
New York Oculoplastic Surgeon

Dysport Around Crow's Feet

Injection too medially into the orbicularis oculi can cause a puffy appearance. I recommend following up with your injector and reviewing photos to determine if it was present before and what your options are for correction.

Harold J. Kaplan, MD
Los Angeles Facial Plastic Surgeon

Weakening the muscle with the Dysport can make the eyelid fat bulge.

I have never seen this be permanent. However, I have seen a few patients who were convinced that botulinum toxin cause fat herniation. When the before treatment photos were used, it turned out it each case that the herniation was present before hand. If you injector did not get before photos-shame on them.

Kenneth D. Steinsapir, MD
Los Angeles Oculoplastic Surgeon

Dysport injection, eyelid bulge

Dysport will not cause any herniation in your fat pad. You should find that your dysport is functional for about 16 to 20 weeks in general. At this point, I believe you have no further action of the injected dysport and likely need a consultation with a board certified physician. Although off label, I have had tremendous success injecting around the periorbit and have been doing so for years.

Todd Christopher Hobgood, MD
Phoenix Facial Plastic Surgeon

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