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Eyelid Drooping, Ptosis from Botox. What Can I Do to Fix the Problem?

I had botox injected into my forhead about 2 weeks ago and now it seems that my right eyelid is not opening up as wide as my left. At first I was mortified and thought I had a seizure and developed a lazy eye but thank fully to internet research I found out that this could be ptosis and is a comman side effect of botox. The Dr only injected the top 1/3 of my forehead (torwards hairline) and I wanted to know if I go back to have between or above my brows injected, would it fix this issue?

Doctor Answers (6)

More Botox is NOT the answer here!


Aizza, I am sorry that you are having this problem, caused by inadvertent migration of Botox molecules to the eyelid elevators, or loss of tone of the brow and eyelid muscles. It will indeed wear off over time, but in the meantime, your injecting physician can prescribe one of several eyedrops that strengthen other eyelid elevator muscles and partially (hopefully near-completely) improve the eyelid droop.

Your description of the injection site near the hairline is an unusual cause for eyelid droop, and in your case may be due to the fact that your basic eyelid position is afected by your frontalis muscle tone. If you look closely at your photograph, the eye that is more "open" also has a brow that is "higher!" Perhaps a bit too much Botox in the right side has decreased your frontalis muscle tone asymmetrically, causing your right brow (and eyelid) to be positioned lower.

Thus, another (not really recommended, but one to consider if all else fails) possible trick would be to inject a bit more Botox on the left side to allow that brow and eyelid to drop as well. You might look tired or sad for a few months, but your brow and lids would match better. Then, get less Botox, regardless of location, next time!

Minneapolis Plastic Surgeon
5.0 out of 5 stars 145 reviews

Botox and drooping or droopy eyelids



Sorry to hear about your problem. Ptosis or drooping of the eyes is one of the most common side effects of Botox. It happens when the chemical toxin affects the muscles which elevate your brow and act against muscles which pull the brow down (depressors). It sounds like your physican attempted to prevent ptosis by staing on the upper brow but may have inadvertently injected the elevator muscles. You options would be to wait until the Botox wears off (on average 3 months) or you could also treat the depressor muscles near the eyes to try to balance things out. My advise would be the conservative route of waiting as you always run the risk of additional asymmetry with further injections. 

Hope this helps you and best luck

Travis L. Shaw, MD
Richmond Facial Plastic Surgeon
4.5 out of 5 stars 9 reviews

It will Improve

It usually improves after a couple of weeks, see your surgeon immediately for other options in treatment

Renato Saltz, MD
Salt Lake City Plastic Surgeon
5.0 out of 5 stars 14 reviews

How to Fix Droopy Eyelid After Botox?


Hi aizza.  In looking at your picture, we do see that the right eyelid appears to cover more of the iris then the left.  With that said, we often see patients that have a slightly different lid elevation before they have any Botox injected.  We capture this in the "before" pictures.  Were any taken of you that you could reference back to?

While it's certainly possible that the injections you received cause eyelid ptosis, it is more difficult to envision this if your MD was injecting only the top 1/3 of the forehead near the hairline.  We suggest going back for a visit to review the "before" photos.  If it does turn out the the injections caused this, the issue should resolve itself in a matter of about 6-8 weeks.  Hope this helps and good luck.

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

Droopy Eyelid After Botox Injection



Droopy eyelid is a complaint that sometimes comes up after Botox injecitons.  Two possible explanations are:

1) The Botox is affecting the muscle that lifts the eyebrow (the frontalis), causing the eyebrow (and the eyelid with it) to droop.

2) The Botox is affecting the muscle that lifts the eyelid (the levator palpebrae superioris).

In either case, the effect should resolve before the Botox wears off in 3-4 months.  

You should see your injector for advice on your particular situation.  If the droopiness is due to weakening of the frontalis muscle, sometimes Botox can be injected to lift the eyebrow (by weakening the eyebrow depressors).  If the droopiness is due to weakening of the levator palpebrae superioris muscle, then there are eyedrops that may be able to lift your eyelid somewhat.

Michael McCracken, MD
Lone Tree Oculoplastic Surgeon
5.0 out of 5 stars 9 reviews

Ptosis After Botox Can Be Fixed

Ptosis is an adverse event of having Botox or any toxin injection. Sometimes it occurs even with the mostskilled injectors. As much as we do not want to see it, this does in fact occur – but rare with experienced injectors.

If you have ptosis, and no matter what the cause is, this ought to be treated. I always recommend going to a board-certified dermatologist or plastic surgeon’s office because we can prescribe eye drops that can be used to minimize the ptosis and help its course perhaps be shorter.

The good thing to know is ptosis is not permanent and will go away over time, as the toxin will as well.

Michael Gold, MD
Nashville Dermatologic Surgeon
4.5 out of 5 stars 9 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.