My Left Eye Lid Droops After Botox, Will it Get Any Worse?

If your eyelids are not actually closing up and difficult to elevate, it is likely you have a drop in your eyebrows as a result of forehead muscle paralysis. The usual contribution of the forehead muscles in elevating the eyebrows is lost from botox dosing. It is also possible to experience a bit of a hooding effect in the affected upper eyelid in this situation. This observation is more poignant in first time botox patients because of the unusual feeling of the loss of forehead muscle contribution in the eye opening motion of eyebrow elevation. Sometime, the injection of botox into the outer fibers of the orbicularis occuli may improve the situation minimally. This condition would typically resolve in 12 weeks as the activity of botox wanes. You should advise your future botox injectors of this issue. They may adjust their botox dosing and points of injection to avoid or ameliorate the problem. True ptosis (inability to actively lift your eyelids) would typically resolve in 6-12 weeks. It does not sound like you have this problem, however, you should consult your physician to ascertain the diagnosis and best cause of action.

 

 

Unfortunately, you are experiencing a rare, but known complication of Botox -- eyelid drooping.The good news is that this is NOT a permanent effect, and you likely do NOT have any permanent nerve damage.  Furthermore, the total effects of Botox set in after 7-10 days so the drooping will likely NOT get any worse, only better...A droopy eye-LID may occur if the Botox is injected too close to your eyelid-elevating muscle, the levator palpebra superioris. In such a scenario, the Botox will diffuse inadvertently onto the levator muscle and cause an eyelid droop. Typically, a lower dose diffuses onto the levator muscle and so the other good news is that the eyelid droop will typically NOT last as long as the full Botox duration of 3-4 months, and may in fact resolve in less than a month -- the likely scenario in your situation.  Note however that if the eyelid droop occurs shortly after injection (i.e. within 3-4 days), then your eyelid levator muscle likely received a significant dose of Botox and your eyelid droop may not resolve for 1-2 months...You may have an increased risk of eye-LID drooping if you have a weakened upper eyelid muscle for neurological reasons, or a deeply set eye-BROW that would be more prone to drooping and result in skin gathering over the eyelid making the eyelid appear like it was drooping. A droopy eye-LID due to Botox can be treated with Apraclonidine eye-drops which can provide a small (2mm) improvement -- Apraclonidine 0.5, 1-2 drops, 3 times per day. Make sure you put in one drop at a time, tilt your head back, and close your eyes to make sure none of the eye-drop leaks out. Be sure your prescribing physician discusses all the potential side-effects of the drops, such as "adrenaline-like" symptoms like anxiety or heart pounding; you may also experience eye irritation, eye dryness, and eye pain, amongst other symptoms. If these symptoms occur, you will likely need to take some lubricating eye drops, lower the dose, switch the eye-drops, or stop the drops altogether...My recommendations are to seek the services of an experienced physician injector. I think the key with Botox lies in truly understanding the anatomy of the injected area, and more importantly the variability in the anatomy between patients -- for brows, the forehead, and anywhere else you plan on receiving a Botox injection. This includes having a firm understanding of the origin, insertion, and action of each muscle that will be injected, the thickness of each muscle targeted, and the patient variability therein. As an aesthetic-trained plastic surgeon, I am intrinsically biased since I operate in the area for browlifts and facelifts, and have a unique perspective to the muscle anatomy since I commonly dissect under the skin and see the actual muscles themselves. For me, this helps guide where to inject and where not to. However, with that said, I know many Dermatologists who know the anatomy well despite not operating in that area, and get great results.Good luck.Dr Markarian

It won't get worse after two weeks. No permanent damage is expected. It will get better; in three months to four it should be gone.

As panel members suggested, time will be your best remedy.  Although frustrating and disappointing, the effects are not permanent and are mainly cosmetic in nature.  

Be certain to address your concerns to the one who did your treatment so that he/she may evaluate the situation, make recommendations, and monitor your progress.

Oftentimes, the condition may be related to forehead dosing rather than a true drop of the eyelid such as in ptosis.  Only an in-person assessment may answer this question.

 

The botox will have its full effect well before 2 weeks, so it is unlikely to get worse. The droopy eyelid can be from two different manifestations.1) If the eyebrow elevator muscles have been treated excessively (forehead lines), then the eyebrow can drop. As the brow drops, excess skin at the upper eyelid will be more apparent (hanging fold of skin)2) If the botox inadvertently paralyzed the eyelid elevator (levator palpebrae), then the eyelid itself will droop (ptosis). You will have a sleepy appearance as if the eye is partially closed.In either case, the result is temporary. But it can last for 3 months or so. If you have ptosis (#2 above), then Iopidine eye drops can lift the eyelid 1 mm or so. Iopidine is an andrenaline based glaucoma eyedrop that also activates one of the minor eyelid elevator muscles. I would not use it all the time, but when you have an important social engagement. Ask your treating MD or local eye doctor for a prescription.Best of luck,John Park, M.D.