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Is it Possible to Raise Droopy Eyelid with Botox? (Photo)

Look at my picture, can you see my eyelid is drooping...I would like this raised,can this be done with a injection of Botox ?. I don't want to have a eyelid lift. Where would you inject and how many units do I need ?

Doctor Answers 11

Non Surgical Brow Lift with Botox

Eyebrows and eyelids can be raised with Botox.  It is referred to as NON SURGICAL BROW LIFT.  It works quite well, but Botox only lasts around 3 months, so re-injections are necessary.  The amount of Botox needed varies from person to person, men usually require more, and you may need "touch ups" after your first Botox injection, until you find the right combination that works for you.  Good luck.


Omaha Plastic Surgeon
5.0 out of 5 stars 54 reviews

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Is it Possible to Raise Droopy Eyelid with Botox?

Thank you for the pictures.

First off, the good news is that this is NOT likely to be permanent and should improve.

It appears that you have a drooping eye-BROW that has caused skin gathering over your left upper eye-LID making the eyelid appear like it was drooping. The eyelid, itself, is not droopy however... 

This droopy eye-BROW may be corrected with Botox...

A drooping eye-BROW may happen in the following scenarios:

(1) When the brow-elevating muscle in the forehead, the Frontalis, receives too high a dose of Botox.

(2) The Botox is sub-optimally placed too low in the forehead -- it should typically be placed at least 1 cm above the Brow.

(3) Over-injection of the glabella area (between the brows).

(4) It may also happen if you have a low set eyebrow to begin with, in which case any Botox to the Frontalis increases the likelihood of a brow droop.

As mentioned above, a droopy eye-BROW from Botox can sometimes be improved with MORE Botox -- this time, the Botox is typically injected into the outside (top of the crow's feet) part of the eye (aka the lateral aspect of the orbicularis oculi muscle) to generate a bit of a brow lift in that area -- by injecting more Botox and paralyzing the orbicularis muscle that normally acts to depress the brow in that area, you may get a slight compensatory brow lift...

Please 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, how deep beneath the skin the actual muscle resides, 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, see the actual muscles themselves, and learn "first-hand" the incredible variability between patients -- live, "on the OR table" -- as opposed to via lectures or a cadaver dissection. For me, this helps guide where to inject and where not to. However, with that said, I know many non-aesthetic trained plastic surgeons and other physicians who know the anatomy well despite not operating in that area, and get good results.

Good luck.

Dr Markarian

Eyebrow lift and eyelid lift with Botox, Ultherapy and Restylane

The preseptal eyelid skin below the eyebrow and above the lower part of the upper eyelid is hanging down. The eyebrow descends with time and with it comes the upper eyelid that it supports.  The forehead muscle helps lift the eyebrow, and therefore, the eyelid. By relaxing the depressor muscles of the eyebrow, the forehead can help lift the eyebrow / eyelid complex better.  This is usually done by injecting the glabella with Botox, often with 3 or 5, and even up to 7 insertions sites, with 15 - 25 units or more being used by most doctors. The outer tail of the eyebrow corresponds to the depressor aspect of the periorbital muscle and can be treated with 2 to 3 units.

Ulthera is focused intense ultrasound energy that treats the forehead tissue and helps induce non-surgical forehead lift by tightening the connective tissue layer and producing more collagen, over six months after the procedure. Ultherapy can be repeated in six to twelve months for more of a boost, but unlike Botox is not intended to need continual treatments as the results of Ulthera can be long lasting.

Lastly, some eyebrows have become so saggy because there is a loss of the infrastructure.  By injecting filler into this layer below the eyebrow it can help support the upper eyelid.  I prefer Restylane rather than Juvederm in the eyelid area as there may be more swelling long term from fluid absorbtion with Juvederm.

Ronald Shelton, MD
Manhattan Dermatologist
5.0 out of 5 stars 33 reviews

Botox can be used to help lift brows

Botox can be helpful in raising the brows but at some point botox alone may not be enough for a significant effect. We are now having excellent results using Ulthera along with botox for lifting the brows and forehead in the right candidates.

Doris Day, MD
New York Dermatologic Surgeon

Using Botox to lift droopy eyelids and brows

It is difficult to tell by the angle of your photo, but it appears as though your brow is the culprit.  It is possible to elevate the brow with the use of neuromodulators such as Botox, and I published a paper approximately 10 years ago which showed just that.  Although results vary among individual patients, by injecting the muscles that depress the brow, such as the orbicularis oculi and the glabellar muscles, up to 5 millimeters of elevation can be achieved.

Corey S. Maas, MD
San Francisco Facial Plastic Surgeon
4.5 out of 5 stars 8 reviews

Miscommunication can be misleading.

I think there is some miscommunication here. The photo shows no droopy eyelid. Maybe you mean eyebrow droop? Even if that is what you meant to say it is difficult to evaluate that because of the angle the photo was taken. I measure  one eye opening space distance and transfer that to the area above your eye lashes and your eye brow is above that distance which suggests no or not much eye brow droop either.

Harlow Hollis, MD
Victoria Plastic Surgeon
4.0 out of 5 stars 2 reviews

Botox Brow Lift

It is possible to achieve a brow lift using botox or dysport.  The degree of correction varies on individual anatomy and what baseline looks like.  To do a complete brow lift and treat the muscles that are responsible for pulling down the eyebrows and eyes we typically dose the glabella  (11's), the lateral brow and the crow's feet  (the orbicularis oculi muscle.)  Another more cost effective option is to dose only the lateral brow and the glabella.  

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

Eyelid drooping (ptosis) can also be caused by eyebrow ptosis

It would be more helpful to see a frontal (portrait) view, but from what I can see in your photo, it's the brow that is drooping, not the eyelid itself.

Brows can droop for a number of reasons, most commonly it's due to volume loss in bone and soft tissue supporting the brow.  If that is the case, a dermal filler such as Restylane or Radiesse can be added on top of the bone above the eyebrow to give it more support and lift.

Brows can also be raised by injecting Botox into the muscles that pull the brow down, the depressors such as procerus, corrugators and orbicularis oculi.  Usually a combination of these treatments is required.

I recommend consulting with a board-certified dermatologist or plastic surgeon with training and experience in these procedures.  Also, make sure that there is a consideration of gender specific brow height and placement when you go to the consultation.  Men and women have different eyebrow structure and placement, and this has to be taken into consideration when having a brow elevation procedure.

Emily Altman, MD
Short Hills Dermatologic Surgeon
5.0 out of 5 stars 4 reviews

Botox and droopy eyelids

Botox Cosmetic is commonly used to temporarily paralyze facial muscles to reduce wrinkling, especially in the brow, forehead and crow's feet areas. One potential complication of Botox injections is temporary sagging (ptosis) of the eyelid. Fortunately, this usually only lasts for a few weeks and can be improved with drops to partially elevate the eyelid.  By weakening the muscles that depress the brow, it is possible to get some brow elevation but this tends to  have little effect on the eyelid. Putting Botox directly into the eyelid will cause it to droop more and is a bad idea.

It is difficult to tell from your picture if you have ptosis and how much is present. The best view would be straight on looking directly at the camera so that the two sides can be compared. It does appear that you have a wide space between your eyelid margin and the crease of the upper lid. If this is true compared to your right eyelid and your left lid covers more of your pupil and iris than on the right, you likely have a separation of the muscle (levator) from it's attachment in the eyelid (tarsus) known as LAD (levator aponeurosis dehiscence).  Unfortunately, this requires a special form of eyelid surgery for correction.

James McMahan, MD
Columbus Plastic Surgeon
5.0 out of 5 stars 15 reviews

Raising Droopy Eyelid With Botox

Injecting a small amount of Botox in the brow depressor muscles will help raise your brow as long as you don't inject the muscles in your forehead that help elevate your brow at the same time.  If your forehead muscles are completely paralyzed, you will not be able to raise your brow.  I use anywhere from 1-3 units to do this. You can expect about a millimeter or 2 of lift.  Although that sounds small, it makes a big difference in this area!

 

Sheri G. Feldman, MD
Beverly Hills Dermatologist
5.0 out of 5 stars 1 review

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.