Botox Caused Permanent Damage to my Eyes. Facing Surgery to Repair? (photo)

PICTURES & MEDICAL DOCUMENTS AVAILABLE.I was injected w/botox only (licensed provider) 19wks ago - forhead & by tear ducts.Within days, I was disfigured horrificially & have not healed. Oculoplastic Surgeon says it is from the botox and it caused so much damage that I may not naturally heal (can email doctors diagnosis). I am 28/healthy w/no medical conditions & now facing surgery due to botox damage. Going to University of Michigan. If you have any suggestions, they would be appreciated.

Doctor Answers 9

I hope you are seeing the oculoplastic surgery service at the University of Michigan.

Dear Mom

Botox effects do not last forever.  But when things are not right it seem like it is forever.  Generally we say that treatment effects last 4 to 6 months.  I have seen individuals who developed ptosis because the agent found its way into the orbit and in rare cases it really took a full year for the atrophy of the muscle to fully recover.  No one has time like that.  It is very depressing to live through that.  You are doing the right thing going to the University for an assessment and you have picked a great institution.  You will recover from this.  My best advice to you is avoid any surgery for a full year and be very wary of quick fixes.  Also, bad botox treatments have a profound effect on our sense of emotional well being that is out of proportion to the symptoms.  Sometimes counseling can be very helpful to deal with these feelings.

Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 26 reviews

Lower Eyelid Problems after Botox

   I can definitely appreciate the contour change for your lower eyelids.  This looks like filler to this area.  The filler can be digested with an enzyme and reduced.  If there was no filler injected and the swelling does not resolve, lower eyelid surgery can be performed to help this area.

Kenneth B. Hughes, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 492 reviews

Botox and "permanent" issues

As you probably are already aware, Botox does not cause permanent results. It sounds like you need further assessment and/or 2nd and 3rd opinions before jumping to surgery.

Sam Naficy, MD, FACS
Seattle Facial Plastic Surgeon
4.7 out of 5 stars 221 reviews

Botox damage

Is it the swelling of the lower eyelids? If so, this can be a temporary effect of Botox injection of the lower eyelids &/or crow's feet. It is definitely not permanent. Should resolve in 6 months, or so. If you had "under-eye bags" , this may need surgery. Please wait a total of 6 months before any decisions, specially if the swelling is worse in the morning & eases off during the day.

Khaled El-Hoshy, MD
Detroit Dermatologic Surgeon

Botox Complication


  • Botox injected into the forehead in the proper locations and in the proper dosage would not cause lower lid swelling unless you had an unusual allergic reaction.
  • I'm not sure why you would have Botox injected near the tear ducts. (Upper and/or lower ducts?) Even so, prolonged swelling what not be expected with small doses.
  • Are your medical documents complete? Did you get the "real" Botox product? Was a filler product injected at the same time as the Botox? Hyaluronic acid products (Restylane/Juvederm) injected in and around the lower lids can result in persistent, long term swelling.
  • Based on the information provided, I see no indication for surgery. Definitely get multiple opinions from experienced plastic surgeons and/or dermatologists before having surgery.

Thanks for your question and best of luck.


Stephen M. Lazarus, MD
Knoxville Plastic Surgeon
4.9 out of 5 stars 9 reviews

Botox does NOT cause permanent damage

Dear kaelynsMom,

I'm deeply sorry you have suffered this much; but please do not decide on a surgery until you have consulted several experts in occuloplastic surgery and have waited a few more months.  If you do require surgery, it will NOT be because Botox caused any permanent damage since that is biologically impossible.  Surgery is infinitely more likely to cause permanent damage than Botox, and at such a young age, it can really alter your appearance.  Fortunately, you photos reveal good improvement in your forehead muscles and brow ptosis from the 1st to 4th month.  Please be more patient. Best wishes.

Daniel Yamini, MD
Los Angeles Plastic Surgeon
4.7 out of 5 stars 20 reviews

I think you should get a second opinion. Botox is extremely unlikely to cause any permanent damage to your eyes.

Please get a second or third opinion before you jump to surgery.  Botox is extremely unlikely to cause permanent eye damage of any kind.

Mark Taylor, MD
Salt Lake City Dermatologic Surgeon
4.2 out of 5 stars 18 reviews

Effects of Botox are not permanent

It may take longer in some people to wear off, but I would hold off on the surgery for 1-2 more months.  It is also helpful to try and exercise the muscles that were injected.  

I am not certain why a Botox injection would be placed by the tear ducts, not a usual location.  One or two units of Botox placed into the lower eyelid, in the fold immediately below the pupil helps relax the lower orbicularis and decrease the lines in the lower eyelid.

Please give it a bit more time.  Botox does wear off because the nerves re-establish new connections with the muscles.

Emily Altman, MD
Short Hills Dermatologic Surgeon
5.0 out of 5 stars 4 reviews

Botox damage

Are you sure you did not receive a filler for your tear troughs?  At four months out, the only thing I can think of that would cause so much boggy, bagging to your lower eyelids is placement of a hyaluronic in that site.  Get your 'licensed' injectors office records and go get a second or third opinion.  What you are showing in your pictures is not the result of Botox.

Steven Swengel, MD
Los Gatos Dermatologic Surgeon
5.0 out of 5 stars 11 reviews

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.