Can my face dropping 4 months after getting lower eyelids Botox be permanent?

Question

I got Botox at the side of eyes, lower eyelids 4 months ago. My zygomatic mussels were hit because my face has completed dropped. My cheeks are drooping, I have chipmunk cheeks, corners of my mouth have dropped (now I have jowls), hollowness under my eyes! It has been exactly 4 months.The lines at eyes are back. Research states it last 3 to 4 months. So I m so worried this drop in my face will last forever. Can’t it last longer than this will just one day my face will go back to normal?!

Kenneth Hughes, MD · Answer

Thank you for submitting your concerns.I am sorry you are experiencing such bad results from Botox. Typically Botox can last anywhere from 3-4 months, with some cases lasting anywhere up to 6 months. Results vary on every patient. I would recommend you consult with a Board-certified plastic surgeon for a second opinion. Best of luck.

Chaitali Nangrani, MD · Answer

As inconvenient as this is, it is temporary and should were off within 6 to 8 weeks. Sorry that this happened to you, although rare, it can happen.

Onir Spiegel, DDS, PhD · Answer

Botox and the other Botulinunes are typically injected along the side of the eyes for crow feet, between the eyes to take care of the 11th and then the frontalis muscles to undo wrinkles along your forehead. It's rare to inject them in the lower eyelids. Typically we treat under eye wrinkles with lasers and fillers in the tear trough area. But, no worries about the botox because if you didn't get the results you were expecting it will only last 3 to 4 months and go back to what you had before. All the best from Boston,Dr. Onir

Katrinka L. Heher, MD · Answer

No worries!! The beautiful thing about Botox is that it is completely reversible when you don’t get the results you were hoping for.  While it last for 3 months the effects can linger for up to 6 months.  You will 100% get back to baseline but just have to wait.  Sorry there is no way to get better more quickly. Good luck!

Camille Cash, MD · Answer

I'm sorry to hear of the issues you are having from your Botox treatment.  Typically the effects of the product gradually fade over 3-4 months.  They sometimes can last longer in some patients, but the results are not permanent.

Douglas Taranow, DO, FACOS · Answer

Sorry you are having issues with your recent botox treatment.  Botox generally lasts only 3-4 months but I do have multiple patients where the effects last up to 9 months.The issues you discussed will not be permanent as the Botox will eventually completely wear off and you should return to your normal state.Best of luck.Dr T

Alex Eshaghian, MD, PhD · Answer

Thank you for your question brainbow. I understand your concern. Botox is a purified protein used to address wrinkles associated with facial expression. When injected into the skin Botox will relax the muscles and smoothen out the overlying wrinkles. The most common areas of treatment are in the upper face. These include the horizontal lines seen on the upper forehead when one raises the brows, the vertical lines seen between the brows when one frowns (frown lines), and the crow's feet seen around the eyes when one smiles.
It is difficult to make an assessment in the absence of consistent photographs before and after in the same lighting and angles for comparison. However, I hope the information provided here is useful.The pivotal studies used 24 units of Botox (12 units per side) to address the crow’s feet. These studies demonstrated that the peak results are seen 14 days after the treatment and most people enjoy their results for 3-4 months. At that point, a maintenance treatment is recommended. While some people start to see results as early as the next day, it can take two weeks for full results so patience is important. We have our patients return two weeks after their treatment to assess their results via photographs. At that time additional units may be added if necessary. 
In the mid face, the zygomaticus muscles sit just below the orbicularis oculi muscle which is treated to address the crow’s feet. When smiling, the zygomaticus muscles pull the corners of the mouth upward. If Botox spreads from the orbicularis oculi muscle downward toward the zygomaticus muscles, these muscles can also become relaxed, leading to the appearance of an asymmetric smile. This side effect resolves on its own in 2 weeks to 4 months, depending on the severity. Some find that laser skin tightening treatments using infrared light or radiofrequency may speed up the resolution process.
If I had a patient with the concern described here I would want to see before and after pictures and I would reassure the patient that the results are not permanent.With any injection, there are risks such as pain, bleeding, bruising, redness, swelling, tenderness, and infection. We take special precautions to minimize these risks such as using a painless technique. We also treat bruises with a laser as early as the next day. Bruises usually resolve within two weeks if untreated. After a laser treatment bruises usually resolve in 1-3 days, but may still take two weeks for full resolution. In addition to these risks, with Botox there is also a risk that the product spreads or diffuses to nearby structures. Spread to nearby muscles can lead to side effects such as the temporary appearance of droopy eyelids or a temporary asymmetric smile.
  
After a Botox treatment, I recommend that my patients avoid heat exposure, alcohol consumption, and strenuous exercise for 24 hours and not lie down flat for four hours. This is because all of these activities may possibly lead to the movement of the product and consequent side effects such as droopy eyelids. Although there have been no definitive studies shown that these actually occur and some physicians do not provide such aftercare instructions, in the absence of data I err on the side of caution and recommend that my patients avoid such activities.
  
Please consult with a doctor for specific recommendations. Good luck!

Leonard Grossman, MD · Answer

It's extremely unfortunate what happened to you and unfortunately even after Botox wears off the dropping may still last somewhat longer although it will not be permanent. More reasons why you should be receiving your treatments with a plastic surgeon or dermatologist. Good luck from New York City

Devrim Elmas, MD · Answer

Nothing last permanent with neurotoxin injections
After 19 years of medical esthetic experience I can tell, all effects will fully wear off. It last 3 to 4 months.
"This answer has been solicited without seeing this patient and cannot be held as true medical advice, but only opinion. Seek in-person treatment with a trained medical professional for appropriate care."
Good Luck.
Dr. Devrim Elmas, MD
Medical Esthetic Doctor
IG: @drdevrimelmas

Can my face dropping 4 months after getting lower eyelids Botox be permanent?

Answers (9)

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