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Poor Dysport Results Last Time, is it Time for Upper and Lower Eyelid Surgery Instead? (photo)

asked 5 months ago by D2012 in Atlanta, GA
Latest answer by Brooke R. Seckel, MD
Question viewed 269 times
Tags: candidate, filler

Always had great results with Botox but went with Dysport last time and results were horrible. Made my eyes smaller, brow lower and lids super puffy. It's worn off now but my lids have become so hooded that they stick together, I raise my brow to see better and I always look mad (due to being 45, not result of Dysport). Do I go with Botox/Dysport again or get upper and lower lid surgery? Or given how my lower lids look, would fillers work instead? Thanks!

14 answers to Poor Dysport Results Last Time, is it Time for Upper and Lower Eyelid Surgery Instead? (photo)

+3

Upper Blepharoplasty not Botox or Dysport is required to correct Eyelid Hooding

Thank you for your question. You have loose upper eyelid skin called Dermatochalasis which must be removed during an Upper Blepharoplasty in order to correct the hooding of your upper eyelids. No amount of Botox or Dysport injected into the frown line and the upper corner of the eyelids will allow the Brow to elevate and correct this. If Botox or Dysport was injected into the Forehead-Worry Lines-this would actually make the Brow drop and the Upper Eyelid Hooding worse. more
Brooke R. Seckel, MD

Boston Plastic Surgeon

www.drseckel.com

+2

Poor Dysport Results Last Time, is it Time for Upper and Lower Eyelid Surgery Instead? (photo)

The truth is there are several ways to treat you. A lot will depend on what you want. If Botox doesn't help you anymore (and this is not certain yet), then you may well need surgery. You should get an in depth consultation with a surgeon who also injects Botox to see what is your best option.
Sam Goldberger, MD

Beverly Hills Oculoplastic Surgeon

www.neweyelids.com

+2

Blepharoplasty and browlift

By your posted story it sounds like the problem is more due to how the injections were made than what was injected, botox vs. dysport. Your current concern seems to be the hooding and that is not effectively or fully treated by botox or dysport. Those neurotoxins are best used to treat skin wrinkles caused by dynamic muscle action. Fillers will not do anything for the upper lid hooding. Therefore the only treatment that will give a reliable result is some combination of upper blepharoplasty... more
Aaron Stone, MD

Los Angeles Plastic Surgeon
+2

Alternative when Botox/Dysport does not work

You have significant hooding of the upper lids from descent of the brow. To improve this, you need some way to elevate the brow. Botox/Dysport can sometimes do this if placed only in the muscles around the eye and not in the forehead (the muscles you need to elevate the brow) and teh forehead muscle is active enough to lift the brow. If you had the forehead injected, this could be one reason for the horrible results. If getting rid of the brow depressor does not result in brow... more
Robert T. Buchanan, MD

Highlands Plastic Surgeon
+2

Botox or eye surgery

Even when i perform a blehparoplasty, Botox is still used for treatment of the facial lines of animation. One does not replace the other.
Steven Wallach, MD

Manhattan Plastic Surgeon
+2

Botox or eyelid surgery

This is not an either or situation. Botox weakens muscle and may be helpful in the dynamic crows feet. The upper lid hooding can be approached with upper eyelid surgery, brow lift, or peels, in various combinations depending on what you desire as a result. Robin T.W. Yuan, M.D.
Robin T.W. Yuan, MD

Beverly Hills Plastic Surgeon
+2

Poor Dysport Results Last Time, is it Time for Upper and Lower Eyelid Surgery Instead?

Perhaps. The photos, aesthetically, show eyebrows that are quite low in position with the left lower than the right. The degree of upper eyelid hooding will increase and decrease with brow position. This degree of eyebrow drop combined with significant upper eyelid housing would most likely require a Brow Lift combined with an upper eyelid surgery IMHO. Be sure the plastic and cosmetic surgeon, you select, understands and follows the proper aesthetics of facial... more
Francis R. Palmer, III, MD

Beverly Hills Facial Plastic Surgeon
+2

Eyelid rejuvenation options

I'm sorry that you had a poor experience with Dysport. To be honest, your result should be the same with either dysport or botox. I don't use Dysport a lot but the product does appear to provide a denser treatment affect than botox, even when comparable (adjusted units) amounts are injected. If the injector is not aware of this, an over-treatment can result, This sounds like your situation (brow ptosis and lid puffiness from an over treated forehead). While wrinkle... more
Richard W. Westreich, MD

Manhattan Facial Plastic Surgeon
+2

Poor Dysport Results Last Time, is it Time for Upper and Lower Eyelid Surgery Instead? (photo)

Photos doe demonstrate a possible need for a blepharoplasty, but try BOTOX again to maybe delay the surgery. But I think you would be more satisfied with a surgery. Good luck.
Darryl J. Blinski, MD

Miami Plastic Surgeon
+2

Lid rejuvenation and Botox work in different ways

Botox along the crow's feet area can tend to relax and raise the brow slightly and open the lid, though upper lid rejuvention works in a different way reducing skin hooding, improving upper lid 'show', and reducing fat or fullness in the inner lid. If Botox pleased you in the past, keep it up, though if the lid hooding is getting you down, it is time for blepharoplasty. Best of luck, peterejohnsonmd.com
Peter E. Johnson, MD

Chicago Plastic Surgeon
+2

Multiple issues to consider.

Finally, a post with excellent photos [except for one out of focus one] so that we can give you an educated opinion. You have 4 different issues at play here: 1. Brow fullness/ptosis: Your eyebrow position is slightly low compared to the ideal brow position for a female. A browlift will address this problem [you probably would be good candidate for an endoscopic lift, though your hairline is not visible in the photos]. This would decreased the brow/eyelid heaviness or fullness... more
A.J. Amadi, MD

Seattle Oculoplastic Surgeon
+1

Poor Dysport Results Last Time, is it Time for Upper and Lower Eyelid Surgery Instead?

I do not think the results you describe are due to the manufacturer of the chemodenervating agent, it is due to injection technique and placement of the mediation. I do think that an upper lid surgery would make your eyes look less puffy and more open. The results of surgery on the lower lids will not be as dramatic as at rest, there is not much excess kin or puffy fat pockets seen.
Julio Garcia, MD

Las Vegas Plastic Surgeon

lvcosmeticsurgery.com

+1

Upper and lower eyelid surgery

Fillers are not indicated to reduce hooded puffy eyelids. According to the pictures presented, you are an excellent candidate for an upper and lower blepharoplasty. The goal of upper lid surgery is to primarily remove excess skin with a small amount of fat, while the reverse is true for the lowers: excess fat is removed from the lower lids to reduce the bagginess and sometimes a small amount of skin is also removed at the lash line when needed. The blepharoplasty procedure... more
William Portuese, MD

Seattle Facial Plastic Surgeon

www.seattlefacial.com

+1

Botox vs.Blepharoplasty (eyelid surgery)

Thank you for the question and the photos. It appears that you may benefit from an upper blepharoplasty (eyelid surgery) to reduce the hooding. You can still use Botox or Dysport for the Crow's feet and forehead area. Hope that helped. Good luck!
Dana Khuthaila, MD

New York Plastic Surgeon

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