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If I Had Eyelid Dropping After Botox Injections to the Forehead Last Time, Will I Have It Again This Time?

About 9 months ago I got 10 units of botox in my forehead, which I had done 3 times before with no problems. But I hadn't been to this doctor before. After this injection, I had drooping of my left eyelid for about 5 months. Now my eyelid is back to normal and my forehead lines have returned. Since I had drooping before, how likely is it that I'll have drooping if I get a forehead injection again, even if I go to a different doctor? Does it indicate my forehead muscles are already too weak?

Doctor Answers (10)

Drooping of the forehead may be a solitary event


There are times in which, even with the same doctor, a patient may get a droop of the forehead and the next time, it doesn't happen. It is helpful for patients to bring to their physician's attention any unbalance or droop so that it can be noted and if an anatomic cause or technique variant is noted that contributed to the side effect, it can be avoided the next treatment. On the other hand, there are patients that have been happy with their botox on their forehead for ten years or so and then in their mid to late forties, the natural course of aging and its forehead sagging does not allow  active forehead lifting to compensate for the relaxation of the muscle that Botox induces and the forehead would droop.

Manhattan Dermatologist
5.0 out of 5 stars 31 reviews

Eyelid drooping from Botox


If you had eyelid or eyebrow drooping after your Botox treatment, make sure to inform your physician so that this can be avoided. In some cases, you may just be a poor candidate for forehead injections and may need to in fact avoid this treatment. Best to speak with an expert injector such as a dermatologist or plastic surgeon to determine this. Dr. Benjamin Barankin, Toronto Dermatology Centre.

Benjamin Barankin, MD
Toronto Dermatologic Surgeon
5.0 out of 5 stars 22 reviews

Are drooping eyelids recurrent with subsequent Botox injections?


The eyelid drooping you are describing is a matter of technique and the number of units injected to that specific area. If the technique is adjusted along with the amount of Botox to that particular site, you should no longer experience this. Every individual is unique in the way they respond to certain treatments, and although what you are experiencing is not completely uncommon, your doctor should be informed of the result so her or she can customize your future Botox treatments to give you the results you are looking for.

Evan Manolis, MD
Orland Park Plastic Surgeon
3.5 out of 5 stars 7 reviews

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Eyelid droopiness after Botox to forehead


You have eyelid ptosis (droopiness) and your brain lifts your forehead/brows subconsciously in order to help lift your eyelids, which is why you have those forehead wrinkles.  Botox to the forehead causes weaking of the muslce responsible to lifting your brows, which will in effect cause your eyelid droopiness to manifest.  In short, you may not be a good candidate for Botox to the forehead (or at least not much).  Consider seeing an oculoplastic surgeon for proper evaluation and management options for eyelid ptosis, etc.

Mehryar (Ray) Taban, MD, FACS
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Botox and eyelid drooping


There is a difference between eyelid drooping and dropping of the eyebrows with Botox.  Eyelid drooping is caused by placement of Botox into the muscle that elevates the eyelid.  Brow dropping can be caused by too many units in the forehead or by too low placement of Botox.  Mention your concern to your physician so he/she will be able to adjust your treatment next time.

Martie Gidon, MD, FRCPC
Toronto Dermatologist
5.0 out of 5 stars 16 reviews

Botox and Drooping of Eyelids


Thank you for the question.

It is important to understand that drooping is one of the commonest side-effects with botox in case of over-dosage. The injection should be placed 1 finger breadth above the orbital rim to prevent such issues, as Botox tends to diffuse from the site of injection.

This does not mean you will have drooping again with the next injection, as it depends on the injection technique and the number of units injected. You can inform your doctor about the previous injection and the problems you faced, so he/she will be more careful

Janani A. Palanivel, MD
India Dermatologist

Botox can cause drooping of the brows and eyelids


Thank you for your question. Botox injected into the brow area can cause drooping of the eyelids if it leaks down into the muscle that elevates the eyelid. To avoid this, is important to inject Botox above the upper rim of the orbit and to avoid rubbing the area or performing strenuous activity for two hours after treatment. Botox injected into the forehead to treat transverse lines in that area can cause the brows to droop somewhat and cause more loose skin on the upper eyelids. This is different from drooping eyelids. To prevent this, I like to leave some of the lower forehead muscles untreated allowing some motion in that area. It was more likely the technique of the injector than anything that you did to cause the drooping.

James McMahan, MD
Columbus Plastic Surgeon
5.0 out of 5 stars 11 reviews

I Recommend Reading About Microdroplet Botox.


This method uses a very specific method of placing botox along the eyebrows to trap the product between the skin and where the muscles of facial expression insert into the skin. This keeps the product from migrating and it also avoid freezing the forehead.  One gets a softer, more relaxed brow that is lifted and the forehead relaxes at the same time.  While the method is patented, this does not prevent physicians from performing the method which is well described in the patent filing and elsewhere.

Kenneth D. Steinsapir, MD
Los Angeles Oculoplastic Surgeon
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Drooping Eyelid is Related to Inadvertent Spread of Botox


True eyelid droop (and not an eyebrow droop) after botox is related to injection technique. While it can happen to the best injectors, its incidence decreases with experience. It is due to unwanted spread of the botox from the forehead muscles to a muscle in the eyelid, and can be prevented by placing the injection higher on the forehead. If it happens again, there are eye drops that can be prescribed to reverse it (iodpidine). Droops that last for five months, however, are more likely due to an eyebrow droop, which will make the eyelid feel heavy although the eyelid itself opens fine. There are no reversing drops for it, and its only solution is waiting for the botox to wear off. Eyebrow droop is also technique dependent, and can be prevented by injecting less botox into the forehead on the affected side next time.

Ramona Behshad, MD
Chesterfield Dermatologic Surgeon
5.0 out of 5 stars 4 reviews

Drooping from Botox...likely to happen again?


Ptosis (eyelid drooping) depends upon site of injection as well as number of units used. And both of these relate to the experience of your injector. If you've only had Botox 4 times in your life, the reality is that the ptosis came from your injection, not from your muscle weakness. If you seek a new injector I would describe exactly what happened last time so he/she is aware of the possibility and can do everything in his/her power to avoid it happening again.

F. Victor Rueckl, MD
Las Vegas Dermatologist
4.5 out of 5 stars 8 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.