Preventing Eye Ptosis from Botox?

How to avoid a droopy eyelid after Botox injections:

Go to a qualified experienced injector--incidence should be less than 1%
It turns out many people who end up with ptosis already have sub clinical ptosis. When the frontalis muscle is injected over aggressively to treat the horizontal forehead furrows, the ptosis can be unmasked. This is because the forehead muscle is compensating for the weakened eyelid muscle. Removing this compensatory muscle causes the eyelid to droop.
Injecting too close to the eyelid muscle when treating the glabella, or the 11 lines.

It has nothing to do with the product and everything to do with the person doing the injections.  As more and more unqualified persons do this injection, the more issues and complaints you will see.
So you need to  make sure that you see a board certified plastic surgeon for you injectable needs.

The advantage of Dysport over regular Botox is that it takes affect faster and may last longer and spreads a little more to cover more creases than regular Botox but that may also cause some more heaviness to the eyebrows for 2-3 weeks if it gets too close to the eyebrows. Neither should have much effect on the eyelids at all as far a drooping goes.

The chance of ptosis is related to how close the toxin is injected to the eye. So it is very easy to avoid by injecting far away from the eye. The problem is that the eyebrow furrow muscles are directly beneath the eyebrows. So if you want a really effective injection than you must inject the muscles directly and the risk for ptosis is increased. It really is a tradeoff. Dysport supposedly spreads more widely than Botox and the concern is that it could cause more potential for eyelid ptosis.
In reality the number of people with ptosis in FDA trials were LOWER WITH DYSPORT than it was wtih Botox

You say that you hear "more and more" about eyelid ptosis after Botox injections. This is because more and more people who are unqualified are injecting Botox. It is important that you go to a qualified injector and not just a spa or "Botox Party." However, even with the most experienced injectors, there is still a very small chance of ptosis. If this does happen, there are eyedrops which can help elevate the upper eyelid a few millimeters until the Botox wears off. Good luck.

BOTOX is effective at reducing glabella frown lines, and eyelid ptosis occurs in less than 1% of patients injected by myself. The few cases I've seen have been mild, and lasted no longer than 6 weeks.
Phenylepherine (OTC) or iopidine (prescription) eye drops are used to treat the ptosis until it wears off.
I hope this was helpful for you.
Best regards.

Studies of BOTOX and Dysport initially suggested an incidence of upper eyelid ptosis of 3 to 5%. These are actually alarmingly high numbers. However in practice the actual incidence of upper eyelid ptosis is much less common. Andectodally the actual incidence is more like one or 2 per hundred treatments (1-2%). However, this does vary by injector. In my last 1000 BOTOX treatments there were no cases of upper eyelid ptosis. The take home lesson is the doctor you go to does make a difference.

It is a misconception that eyelid drooping (ptosis) is common. It is more of the brow ptosis. What happens is that your muscle of the forehead that pulls up your eyebrows is paralyzed to reduce forehead wrinkles. Since it can not lift up your brows, the droopy brows cover the upper eyelids and make it look like eyelids are droopy.
This can be avoided by either not injecting into the forehead muscle or trying to stay at least one inch above the eyebrow level.
The risks are the same for Botox and Dysport.
Regards

True eyelid ptosis is when the upper eyelid muscle weakens and the eyelid comes down further on the pupil. This occurs very uncommonly. This is from Botox injected into the muscles around the eye socket diffusing into the upper eyelid.
What is more common is brow drooping or ptosis. This can be avoided or predicted in most patients. Treating the forehead lines relaxes the frontalis muscle that raises the forehead. Many patients already have overhanging eyelids or low eyebrows. They habitually hold their brows up with the frontalis muscle to relive the heaviness. If the frontalis is treated with Botox, this compensation is eliminated.
Some patients can even get a browlift with properly placed Botox. As stated above, you should seek out a skilled, well trained physician for Botox treatments.

It is important to distinguish between Eyelid ptosis and Eyebrow ptosis.
Eyelid ptosis occurs when the eyelid excursion (ability to open and close) is diminished and the upper eyelid begins to cover the pupil, interfering with the upper visual field.
Eyebrow ptosis is when the eyebrow position is too low, and falls below the bony rim of the eye socket. This can make a patient appear as though the eyelid cannot open, when in fact there is nothing wrong with the eyelid muscles.
Both conditions can occur in patients who have had botox injections. The best way to prevent either of these from happening is:
1) Have a doctor inject you who is very familiar with the pertinent anatomy of the face.
2) Do not rub any area for 24-48 hours after injection. Doing so can cause the botox to migrate.
3) Avoid excessive exercise for 24 hours after injection.
Dysport works in the same manner as botox and can therefore exacerbate both of these conditions as well.