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Puffy and Drooping Eyelids After Botox

I have severe puffy and drooping eyelids after Botox. What can be done? Botox eye droop. I also have severe puffiness in eyelids. I was injected in the forehead and between brows. I still have the one wrinkle I wanted gone between brows...ARGH.

Doctor Answers (4)

Puffy Eyelids After Botox


Hello.  It's difficult to see from the photo how much eyelids because we don't have the "before" picture.  The good news is that because Botox is only temporary, the effects usually only last about 6-8 weeks.  

The condition is called ptosis and it occurs when the Botox is injected incorrectly in the forehead.  The product migrates to muscles that are not targeted.  The Botox relaxes these muscles and causes the eyelids to appear heavy or puffy.  Iopodine drops may help speed the resolution of the problem.  Ask your injector about them.

As for the crease that remains in between the eyes, it looks like you may need some dermal filler.  Your injector should have set the expectation that a deep furrow line like this might need Botox AND dermal fillers.  Good luck.

Los Angeles Facial Plastic Surgeon
5.0 out of 5 stars 6 reviews

Botox in brows


Botox injected into the brows can cause sagging and a heavy lid look in some individuals especially those with heavy brows.  See your doctor.

Steven Wallach, MD
Manhattan Plastic Surgeon
4.5 out of 5 stars 17 reviews

Botox in the forehead can cause eyebrows to sag


The forehead muscles are responsible for raising the eyebrows, so if you inject Botox there, you run the risk of not being able to raise your eyebrows. (I always caution my patients of this side effect, and undercorrect the forehead). Unknowingly, you must have been using your forehead muscles (frontalis) to raise your brows and keep the eyelid skin up. Once the eyelids droop, it can look like puffiness because the excess eyelid skin is bunching up.

Now that your brows are drooping, you can try doing exercises to raise your eyebrows and strengthen those muscles. This can help the Botox wear off quicker. Sometimes taking Calcium supplements can also help to speed up the Botox metabolism. Other than that, there's nothing else to do but wait.

The good news, though, is that now that the Botox is working you just need a little drop of Restylane or Juvederm to fill in that pesky line that's bugging you and you will have a smooth line free forehead.

In the long term, you may wish to consider upper eyelid surgery with eyebrow fixation for a more permanent and aesthetically pleasing result..

Jonathan Hoenig, MD
Beverly Hills Oculoplastic Surgeon
5.0 out of 5 stars 32 reviews

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This is due to the brows dropping after Botox


Your eyebrows have descended a bit after the treatment. This is a result of the BTX taking out the muscles that elevate the forehead. As a result, the skin of the upper eyes tends to become redundant and puffy looking. If you manually raise your brow, you will see an improvement to the pre-injection state.

One way to correct this is to have your doctor inject the muscles that are pulling the forehead down unopposed. While he is at it, give another bit to the wrinkled area.

The other option of course is to wait it out, which usually takes 3-7 months.

Hope this helps.

Scott E. Kasden, MD
Dallas Plastic Surgeon
4.5 out of 5 stars 47 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.