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Upper Blepharoplasty After Botox?

I get Botox to treat my crows feet every 3 to 4 months (for the past year). I would like to have upper eyelid Blepharoplasty to reduce baggy skin in my upper eyelids. I have heard that treating crows feet with Botox can create a temporary brow lift and reduce some of the redundant skin in the upper eyelid, and therefore it is best to have all the Botox worn off before doing an upper Blepharoplasty.

On the other hand, I have heard that having the Botox in the eye area prior to upper Blepharoplasty can be positive, since it reduces movement during healing and can help improve scar appearance. When is the best time to have an upper Blepharoplasty following Botox for crows feet? If it is best to let the Botox wear off, is 4 months sufficient time for the effects of Botox on lifting the brow to wear off, or should I wait 6 months before undergoing Blepharoplasty surgery?

Asked 35 months ago by Apple123 in Toronto

Timing of upper blepharoplasty, forehead lift, and Botox

It depends on your reasons for the Botox. If the only reason you get Botox is for the crow's feet than it should not really effect the upper blepharoplasty and I would proceed. If you get Botox because of the forehead lift secondary effects you may want to consider a transblepharoplasty browpexy or a browlift procedure with your upper lid blepharoplasty. There are many reasons for a browlift. Occasionally excess upper lid skin can cause you to compensate by using your forehead muscles to... more

Otto Joseph Placik, MD

Chicago Plastic Surgeon

ASAPS ASPS

Prudent Botox use helpful for forehead lifts and blepharoplasty

Thanks for your question. I find that the prudent use of Botox iseful for forehead lifts and eyelid tuck procedures (blepharoplasty). Botox is typically administered at least 3-4 weeks prior to the procedure. Botox is administered to reduce the pull or tension of key muscles to assist in optimizing the healing phase. Botox may be helpful for scar control. This would be used in areas where the underlying pull of the muscle is placing tension on the wound (scar). Whether it would be... more

Stephen A. Goldstein, MD

Denver Plastic Surgeon

ASAPS ASPS

Best to let Botox wear off

In order to get a true read on your anatomy and what you would like surgery to achieve, you should let all effects of Botox wear off. Botox itself doesn't cause the eyebrow to raise up, it is where you place the Botox that does that. Botox is blind to what muscle it affects and each muscle around the eyelids and eyebrow has a certain job. Placing Botox in one muscle group can allow the eyebrow to elevate by relaxing the depressors while another muscle group will cause it to fall by weakening... more

Robin T.W. Yuan, MD

Beverly Hills Plastic Surgeon

ASPS

Botox and upper lid blepharoplasty

Let the botox wear off before having surgery . This should only take 3-4 months. You can restart Botox after surgery when the incisions are healed.

Steven Wallach, MD

Manhattan Plastic Surgeon

ASAPS ASPS

Okay to have botox

It is okay to have Botox either before or after a blepharoplasty and will not affect the results of the upper or lower eyelid blepharoplasty. Botox for crow’s-feet will not affect the results from blepharoplasty.

William Portuese, MD

Seattle Facial Plastic Surgeon

Wait if Botox was injected under lateral brow

If you have had an under the brow injection of botox you should wait until the botox wears off. If your brows "lowered" after the botox treatment you should also wait.

Richard Gentile, MD

Cleveland Facial Plastic Surgeon

OK to perform Blepharoplasty with Botox in place

You will know how much of a browlift you really received from Botox treatment of your crow's feet. Although it is best to have the Botox effects removed prior to blepharoplasty, in most cases, it is not a big issue. If you receive your Botox from the same surgeon who will perform your eyelid procedure, s/he will know anyway. Some patients get a dramatic (undesirable?) devil's peak effect of the brows after botox. In this situation, your surgeon will likely recommend holding off with the... more

Frank P. Fechner, MD

Worcester Facial Plastic Surgeon

If you will continue using Botox, you can have the blepharoplasty anytime.

Hi! Presumably you like the results of Botox and will continue to get it every 4 months. So this is a stable situation. In any case, if your eyebrows drop, the solution is NOT to take out more skin during the upper blepharoplasty. That just drags the brows further down. The solution in that case is a brow lift (there are several different kinds).

George J. Beraka, MD

Manhattan Plastic Surgeon

ASAPS ASPS

Best to allow the Botox to wear off

Dear Apple123, Ideally, you would allow the Botoxto completely wear off prior to eyelid surgery to have the most accurate pre-operative assessment. The Botoxwill have an effect on the position of the brow and how much skin hangs into the eyelid. The most important issue is of course, how exactly was the Botoxdone? Having said that, the very last millimeter of skin should not be removed from the upper eyelid during the blepharoplasty. An upper eyelid fold should be preserved to avoid... more

Kenneth D. Steinsapir, MD

Los Angeles Oculoplastic Surgeon

Botox and Blepharoplasty

I respectfully disagree with my colleagues. Most patients that have blepharoplasty continue their Botox treatments afterwards. I feel that the modern principles related to upper blepharoplasty actually involves SOOF volume replacement along with skin rejuvenation and - if necessary - conservative skin removal. The older tenants of maximal skin removal with aggressive middle and medial fat compartment resection, in my opinion, leave an unnatural look. After Botox, healing of the eyelid... more

Daniel Reichner, MD

Newport Beach Plastic Surgeon

ASPS

Let Botox wear off before upper lid Blepharoplasty

I agree that it is best to let the Botox wear off before Blepharoplasty, so that the brow position is normal and not reducing upper lid skin for removal. Surgery does lessen the effect of Botox, so I would wait 6 weeks after surgery for your next Botox treatemnt.

Doctor's Website

Brooke R. Seckel, MD

Boston Plastic Surgeon

ASAPS ASPS

Wait 4 to 6 months after Botox to have surgery

You are correct. It is best to wait four to six months after Botox Cosmetic to have a blepharoplasy. If your muscle movement is back (the Botox has worn off) then it is okay to proceed with the surgery. The concern is that if you have Botox in your crow's feet, there is a minor lift to the lateral eyebrow. When the Botox wears off, this lift will go away. If you had the surgery when the Botox was there, the surgeon may not take out all of the redundancy. Alternatively, you may also... more

Doctor's Website

David Shafer, MD

New York Plastic Surgeon

ASPS

I do not mind if my patients have had Botox prior to Blepharoplasty

Bleparoplasty and browlifts are two different procedures performed for two different reasons but they can affect one another. In my practice when marking the upper eyelid I consider the ideal eye brow position in mind at all times. Botox could be beneficial prior to bleph. as it may raise the eye brow to ideal possition so that the right amount of skin could be removed from the upper eye lid.

Amir Moradi, MD

San Diego Facial Plastic Surgeon

You should hve upper eyelid surgery without Botox effect

The concern that Botox will elevate the lateral brow and will effect the surgery result is true. The best result will be if there is no botox and your muscles are working normal.