How Soon After Having Botox Would a Ptosis Show Up? Hours? Days?

Question

I had botox to the glabellar and crows feet 2 days ago and my new practitioner also gave me a half unit towards the upper, outer corner of my eyebrows too stating that this would raise my saggy eyelids. I've never had this before with my previous botox practitioner and am worried that this botox will actually cause my eyelid to droop?

Ron Shelton, MD · Answer

The periorbital eyelid muscle curves down at the tail of the eyebrow for most patients (some may shape their eyebrows differently and the true landmark of the bony orbit around the eye should be checked by the physician prior to injeciton). Botox in this depressor muscle of the eyebrow can help lift the eyebrow / eyelid complex. Usually one or two units is injected, for this off-label used of Botox. Drooping should not occur in this area. IF the technique was not the one mentioned above and a droop does occur, it can be seen even a week later but usually it starts a few days after the Botox.

Kenneth D. Steinsapir, MD · Answer

Just because you had a small amount of BOTOX in the eyebrow does not mean that you will develop upper eyelid ptosis. I routinely inject the eyebrows using Microdroplet BOTOX which does not cause upper eyelid ptosis.

Harold J. Kaplan, MD · Answer

Using Botox or Dysport to treat the lateral brow area for a subtle lift is a common and rewarding technique.  As with any injections in this area, technique and dosing are important to avoid an unintended outcome such as ptosis (drooping of the upper eyelid).  

	If you were to experience an adverse outcome, you would be aware of this within a few days.  As other panel members suggested, a half unit dose will not offer any benefit for this technique.  In our practice, we generally use 5 units per side.

	Browse our photo gallery by following the below link for before/after photos of what a "brow lift" looks like.

Grant Stevens, MD · Answer

Ptosis can occur as early as the first 3 to 7 days.  I do not expect you to experience any ptosis due to the description you gave.  This is a very common area of injection and I suspect you will be happy with the end result. 

	Good luck.

	 

	Dr. Grant Stevens

Steven Wallach, MD · Answer

If you were to develop ptosis with Botox it usualy takes about 5-7 days fo the full effects of Botox.

Michel Siegel, MD · Answer

It takes about 3 days for BOTOX Cosmetic to start working, so around that time you would notice it. The more diluted the BOTOX used, the more it will diffuse to other areas, and thus, the higher rate of Ptosis.

Gordon Lewis, MD · Answer

The rate of getting eyelid ptosis from botox is very low in experienced practitioners.  I have yet to "drop a lid" in one of my patients (knock on wood! :-) ).   I tend to think you are at higher risk of ptosis from the glabellar injection than the lateral brow injection. 

	I frequently inject the lateral brow.  Depending on where it is injected, this can cause a decrease in crows feet and/ or an elevation of the lateral eyebrow.  The eyelid itself is usually not improved. 

	Good luck and don't worry!

Francis R. Palmer, III, MD (retired) · Answer

Effects of neurotoxin injections (Botox, Dysport and Xeomin) peak between 3 and 7 days with 5 as the average. You would expect ptosis to occur by that time if it's going to happen at all. Having the Botox injected by an MD that understands and follows the proper aesthetics of facial beauty also help IMO.

How Soon After Having Botox Would a Ptosis Show Up? Hours? Days?

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