Can ptosis from Botox cause permanent eye dropping issues?

Question

I went to a board certified plastic surgeon in 2008 for botox. Was new to botox and didn't realize she was having an assistant inject it, resulting in severe eye ptosis in my right eye. The severe ptosis eventually went away, but whenever I am tired or have had 2-3 drinks, the eyelid droops. Is this a result of the botched botox or just something normal w/ age? Never noticed the problem until after the awful botox incident, but that could be because I just didn't notice it. It really bothers me

Kyle Coleman, MD · Answer

Increased laxity of the upper lids and loss of volume of the bony prominences of the brow leads to brow and eyelid droop over time.  This can be exacerbated by swelling, lack of sleep, etc.  Botox can rarely cause a temporary brow ptosis or eyelid ptosis.  This ptosis should resolve over time and have no ill effects long term.  It is most likely that the bad experience has made you hyper aware of the area.  Seek a consultation with an expert in facial aesthetics to evaluate your surgical and non-surgical options to address the problem.  Make sure to have an open and frank conversation about previous experiences and expectations prior to initiating any therapy.

Andrew Campbell, MD · Answer

Botox can only temporarily effect a muscle. The muscle always returns to normal over time, so the very unfortunate problem you had with a prior Botox injection can not cause a permanent problem. A personal exam would be necessary to determine the cause of your droopy eyelid. More than likely, had you not had that Botox injection in the past, you would still be dealing with a droopy eyelid today. Fortunately, it is only noticeable in the circumstances you mention. If it really bothers you, see an eyelid specialist.Andrew Campbell, M.D.Facial Plastic SpecialistQuintessa Aesthetic Centers

Nelson Castillo, MD · Answer

Thank you for your question and I am sorry to hear of your issues following botox.  Because botox only has temporary effects, I do not think that your eyelid issues after drinking are the result of your injection in 2008.  What can develop with age and gravity is excess upper eyelid skin resulting in excess skin that can impact your eyelid position.  You may be a candidate for an upper eyelid lift, or blepharoplasty.  Hope this helps.

Anthony Deboni, MD · Answer

Botox causes a temporary effect.  Given the length of time from the injections, the ptosis you have is not related to the Botox.  Best Regards.

Margaret Weiss, MD · Answer

Botox effects are temporary, so it is highly unlikely that your current eyelid drooping is related to your previous Botox injections. I would suggest visiting an eye specialist to find out why your eye droops in these specific conditions.

Todd C. Miller, MD · Answer

Hi KatieD, one of the unfortunate complications that can occur from Botox injections is ptosis. This typically wears off in 3-6 months. The brow droop that you are describing now is most likely secondary to the natural aging process.

Joshua A. Halpern, MD, PA · Answer

Thank you for your question. The effects of Botox is not permit. You may have other issues going on. I would recommend that you get evaluated. If botox is injected to close to the eyebrow centrally, this may migrate affecting the muscle that lifts the eyelid. If if to much Botox is injected into the frontalis (the muscle that elevates the eyebrows)  then your eyebrows can severally droop, which can affect your vision.

Christopher Dannaker, DO, MPH, FAAD · Answer

Botox even in the extremely rare and unfortunate circumstances of being injected directly into the nerve bundle above the eye resolves after about 9 months.  Perhaps you had a pre-existing weakness on this side, hence the Botox years ago effected it more due to a possibly slightly misplaced injection.  As you age this weakness is probably becoming more noticible.  In fact, it is likely properly admistered Botox could improve it.  Surgery is often another good option if the patient is amenable.  Your board certified plastic surgeon will be able to advise you.

Nicholas Tarola, MD · Answer

I'm sorry to hear of your eyelid problem.  The Botox is not the cause as the effects of Botox are limited to only a matter of months.  Your eyelid drooping is unrelated but can potentially be fixed surgically or nonsurgically.  I recommend you see a board certified plastic or oculoplastic surgeon to discuss your options.  Best wishes!

Elena Vega, DO · Answer

The eyelid ptosis you experience after drinking is unrelated to the Botox injections you received in 2008. Since it really bothers you, I would recommend you follow up with an oculoplastic surgeon or an ophthalmologist for further evaluation.

Can ptosis from Botox cause permanent eye dropping issues?

Answers (13)

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