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Risk of Drooping Eyelid for Crow's Feet Botox Injection?

I am considering Botox for crow's feet wrinkles. I have no forehead wrinkles to speak of. I am concerned about problems with my eyes and drooping that I keep reading.

Is there still a chance of eyelid drooping if I only get crow's feet done? Does eyelid drooping only occur when injecting the forehead?

Doctor Answers (7)

Drooping eyelid after Botox.


This is actually an excellent question.

Of course the most common cause of drooping of the UPPER eyelid is inadvertent injection into the eye lifting muscle, or aggressive forehead Botox, causing the forehead to descend excessively.

However, when Botox is used for the crow's feet area, it can deactivate the orbicularis muscle. this can cause drooping of a borderline weak lower eyelid, or exacerbate cheek droop that a patient has, causing LOWER eyelid drooping. To understand the effect on each of the muscles on cheek and lower eyelid positioning, we have some literature below.

Beverly Hills Plastic Surgeon
5.0 out of 5 stars 100 reviews

Eyelid droop not a concern if you are only injecting crow's feet


You can be confident that you are at almost no risk for eyelid droop if you are only having your crows’ feet injected. Actually, by injecting the superior aspect of the muscle that causes crow’s feet, you can gain a slight lift to the outside eye area.  

Dan Mills, MD
Orange County Plastic Surgeon
4.5 out of 5 stars 19 reviews

The percentages are with you with Botox for crow's feet


Experienced Botox injectors have great success with the crow's feet. As usual, best to be conservative; you can always add more.

Yes, if the forehead injection is not ideal, the Botox can spread downward and cause the muscle that keeps the upper eyelid "up" to weaken and hence the droopy upper eyelid.

This is rare. It can also occur when injecting to position the outer eyebrow. It is possible to raise the outer (towards the ear) portion of the eyebrow by judicious Botox injection. That takes a expert with long experience. If that were done imperfectly, the same problem with the upper lid could occur.

Since you are most concerned with the crow's feet, tackle those first.

Robert Kotler, MD
Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 59 reviews

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Can your eyelids droop with Botox in crow's feet?


Generally, the risk of this should be slight. Brows and upper eyelids can droop with injection in the forehead or the glabella. Accurate evaluation of your face before placement of the product is essential. The droop, called ptosis, is unusual and goes away. We have not seen eyelids droop with the amount of Botox we place in crow's feet. If a large amount is used in already week eye muscle, it could happen. You should be evaluated by a physician who does a lot of these injections.

Stuart H. Bentkover, MD
Boston Facial Plastic Surgeon
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Crows Feet and Botox


The major risk for eyleid ptosis is usually from Botox injected in the area just below the eyebrow or in the area between the eyebrows.  Generally if done by an experienced board certified physician,  Botox is virtually 100% safe!

S. Randolph Waldman, MD
Lexington Facial Plastic Surgeon
4.5 out of 5 stars 7 reviews

Slim Chance


I say slim chance because in medicine we are taught never to say never or no chance.

The muscle that would be affected to cause a lid drop or "quaz" is the Levator Palpebrae. This muscle is pretty far removed from the lateral portion of the orbicularis oculi muscle which is the muscle injected to ameliorate "crow's feet".

In fact of all the areas injected with Botox the crow's feet are probably the safest and least likely to give you problems. It is a good way to dip your feet into the Botox waters.

Arnold R. Oppenheim, MD
Virginia Beach Dermatologist
4.5 out of 5 stars 10 reviews

Drooping Eyelids from Crow's Feet Botox?


Generally eyelid droop comes from injections into the forehead above the brow.  That's not to say it's impossible for what you are describing to have happen, but it would be very unusual. 

It would be more common to have a problem with saggy under eyes when injecting the crow's feet poorly, so the risk is more below the eye than above it with this type of injection.

Harold J. Kaplan, MD
Los Angeles Facial Plastic Surgeon
5.0 out of 5 stars 6 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.