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Sagging Lower Eyelids After Botox

asked 1 year ago by Toronto8610 in Toronto, ON
Latest answer by Mike Majmundar, MD
Question viewed 809 times
Tags: cheeks, lower eyelids, sagging

Can injecting around the upper cheek area under the outer edges of the eye cause muscle weekness affecting lower eyelid sag. I was showing the signs of crepey lower eye lid but it looks so much worse now after the botox because it seems my eyes are too weak to hold the skin up? Is this common? I realize that other parts of the look better but this was the second time I have had botox and didn't have this problem.

14 answers to Sagging Lower Eyelids After Botox

Botox for crows feet and effects on lower eyelid

Yes. You are using the circular eyelid muscle to help keep the lower eyelid in position and the cheek muscles help support it as well so if there is a combination of weakening in both of these muscles, then you may notice some sagging of the lower eyelid skin. It is not permanent and will return to baseline after the botox wears off. The lateral cheek area is an area that is to be respected in terms of botox injections.

Ronald Shelton, MD
Manhattan Dermatologist

Sagging lower eyelids after Botox injections

Botox, when aggressively injected to the side of the eye, can deactivate the cheek lifting muscles and cause the cheeks to slip downward, making the lower eyelids bulge more. That is the mechanism for your problem. Many patients who have been getting Botox injections start to notice this problem becoming more and more pronounced as the native cheek drifts further down and deflates. For those patients, we usually perform a cheeklift with fat-fascial grafts.

Brent Moelleken, MD
Beverly Hills Plastic Surgeon

Sagging lower eyelids from Botox

Botox injected too close to the edge of the eyelid can cause the circular muscle around the eye to relax causing this portion of the eyelid to also relax and it may appear as if the eyelid is droopy. This is a temporary effect and will improve as the Botox wears off. This same injections are performed in individuals who have small eyes to enlarge them. In any case, let your surgeon know what happened and to avoid this area in the future.

Mike Majmundar, MD
Atlanta Facial Plastic Surgeon

Botox for crow's feet resulted in sagging of lower eyelid

Botox does not necessarily have the same distribution each time it is injected. This may account for the differences seen from one injection to the next, Botox will weaken the sphincter action of the orbicularis oculi which may produce some weakness in the lower eyelid when injected into the crow's feet area. T

Otto Joseph Placik, MD
Chicago Plastic Surgeon

Lower Eyelid Sagging with Botox Cosmetic

Hi Toronto8610 in Toronto, ON, As other specialists have already stated, neuromodulators such as Botox Cosmetic may contribute to sagging of the lower eyelid. Crow's feet wrinkles or treatment in the sides of the eye typically do not result in eyelid sagging, but rather Botox injections lower on the eyelid or cheek may. Any sagging from Botox should eventually resolve within a few weeks or months. You may consider a lower dose or avoid treatment in the area all together next time.... more

Houtan Chaboki, MD
Washington DC Facial Plastic Surgeon

Lower lid drooping after Botox

Aggressive injection of neuromuscular blockers in the cheek, usually for undesirable "smile lines", can cause sagging of the lower lids, even the inability to smile or an asymmetrical smile. These changes are usually temporary and should resove in a few weeks to months. In the meantime, I suggest you consider warm compresses to increase the bloodflow, facial smile exercises, and even direct muscular stimulation by tapping over the cheek and cheekbone to keep... more

Randy Wong, MD
Honolulu Plastic Surgeon

Yes, if the skin is lax or if over injected

This side effect can occur in older patients with lax skin tone under the eyes (a slow lid snap), or if the doctor grossly over injects the lower lid. It can cause the lower part of the eye to show and give a very sad appearance. Unfortunately, it will have to improve gradually since there is no fix for this. It occurs from either poor injecting or poor judgment or both.

Mary Lupo, MD
New Orleans Dermatologist

Sagging lower lids after botox

Botox injected into the lower lid area can cause diminished lower lid tone and lead to the appearance of "sagging lower lids". Botox is wonderful for crow's feet but care must be taken when injected into the lower lid. Patient selection is critical when performing these injections. The good news is the effects of botox are reversible and this will resolve on its own. inform your doctor of your result and avoid future injections in this area. good luck... more

Robert W. Kessler, MD
Orange County Plastic Surgeon

Sagging lid after botox will go away.

Sagging lid after botox will go away given a few weeks. There is nothing to do for now. Next time have your surgeon use a weaker dose.

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon

Can be done but this is the risk.

Generally, under eye fillers is a much safer because it tend to support the lower eyelid position. The lower eyelid is delicately balanced against the eye by muscle tension. Mess with that and the lid slumps. Good news is that the effect wears off. Avoid this treatment in the future.

Kenneth D. Steinsapir, MD
Los Angeles Oculoplastic Surgeon

Sagging Lower Eyelids After Botox

Very possible but the good news is Botox wears off within a few months. Than forget about having it re injected in those areas. From MIAMI regards Dr. Darryl J. Blinski

Darryl J. Blinski, MD
Miami Plastic Surgeon

Botox for undereye wrinkles

Botox does wonders for crows feet as well as for undereye wrinkles that are caused by excessive movement of the muscles. That being said, if someone has a lot of loose skin under the eyes and crepiness (loss of elasticity, etc), then I typically never treat infra-orbitally and very conservatively (low units) will treat the lateral lines. Sagging of the lower lids is an issue whenever there is skin laxity and needs to be addressed as a potential problem prior to injecting this... more

Radha Mikkilineni, MD
Washington Dermatologist

Botox and lower lids

I avoid Botox in the lower lids because it can cause scleral show and be uncomfortable for the patient.

Steven Wallach, MD
Manhattan Plastic Surgeon

Botox can cause lower eyelid sagging

Occasionally Botox injected to the crow's feet can temporarily weaken the muscles of the lower eyelid and cause some sagging of the lateral lower eyelid (the side toward the ear.) It will resolve in a few weeks or at most a few months. Next time you get Botox into the crows feet the doctor should keep the injections a little higher, away from the lower eyelid.