Botox Caused Paralysis? (photo)

Patient had 5 Botox injections in eye area and face. Botox Prescribed and Injected by an Opthamologist for chronic muscle twitching below right eye. 3 days later she went back to doctor because she still cannot open her right eye and has paralysis in right side of face. Dr. said ' this happens occasionally", that if it does not correct itself - he may have to do SURGERY! Any advice would be appreciated. Thank you.

Doctor Answers 6

Botox is temporary, including the complications

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ophthalmologists inject botox for essential blepharospasm and possibly twitching. The Botox temprorarily relaxes the muscles. if there is diffusion of its effect to the other nearby facial muscles, it could prevent closure of the eyelid during sleeping which could dry the eye, and can even affect the opening of the mouth, which has appeared to have occurred in this photograph of the right mouth. These treatments must be performed by experienced board-certified ophthalmologists or oculoplastic surgeons. I can't imagine why surgery would be needed! The muscles will wake up in 12 to 16 weeks.

Manhattan Dermatologic Surgeon
4.9 out of 5 stars 39 reviews

Droopy eye

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This is one of the problems that can arise with botox but fortunately it is reversible given time.You may want to see your eye doctoras well.

Robert Brueck, MD
Fort Myers Plastic Surgeon
4.9 out of 5 stars 69 reviews

Just wait for bad Botox results

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Botox works by relaxing (paralyzing) the affected muscles.  It appears they Botox has affected the levator muscle which opens the eyelid.  I would strongly recommend against any surgery for at least 4-5 months, as most likely the Botox will wear off and further intervention won't be necessary.  There may be treatment options to help temporarily.  I would search out an occulo-plastics specialist for a second opinion.

Michael Bowman, MD
Roanoke Facial Plastic Surgeon

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Absolutely do NOT do surgery for a bad Botox result

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Botox is temporary, even when it's a bad result. This is why I say time and again that we are lucky there isn't "permanent Botox". There is absolutely no need to do a surgery to correct this, time will correct it.

We Do Not Perform Surgery For Eyelid Ptosis After Botox.

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An important issue is who did the botox injection.  It is very helpful to see a sub specialist for this issue, either an neuro ophthalmologist or an oculoplastic surgeon rather than just a general ophthalmologist.  The reason is that getting this treatment right requires a great deal of experience.  The droop eyelid could take one to 4 months to resolve.  Just because she had a bad outcome with this botox treatment, it does not mean that this will always be the outcome.  Going to the right doctor makes a huge difference.  Even now, seeing a oculoplastic surgeon is helpful to be assessed to determine if eye drops to improve the opening of the eye would be beneficial.  The American Society for Ophthalmic Plastic and Reconstructive Surgery maintains a geographic directory on their website to help you find a well qualified oculoplastic surgeon.

Kenneth D. Steinsapir, MD
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 26 reviews

Botox and Paralysis

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Botox works by inhibiting muscle movement.  In this case it seems like a lot of Botox was injected and affected the muscles that help keep the upper lid open.  In addition, if the Botox was injected too far down on the cheek, it will cause drooping of the side of the face.

I would absolutely NOT advise any surgical intervention for at least 6 months or longer. Usually Botox only lasts that long, and you will probably start to see improvement before that time.  So if the problem is due to Botox, it should resolve.  Your injector may also want to give you Iodipine drops to see if that helps the upper eyelid droop.  This is very unfortunate, but please give it time.

Sheri G. Feldman, MD
Beverly Hills Dermatologist

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.