Botox to Correct Wrinkled Eyelid?

Question

I am 47 and am getting a vertical wrinkle in my eyelids (from the brow area to lid). Is botox an appropriate corrective measure for this or is surgery required to correct?

Ron Shelton, MD · Answer

If your vertical crease is extending from the eyelash part of the eyelid, or slightly higher, upwards to the eyebrow, then you probably will not obtain benefit from Botox injections at the crow's feet (outer eyelid) and Botox can cause a significant drop of the upper eyelid if injected in the area of your vertical crease! This drop can last more than three months. See a board-certified dermatologist, plastic surgeon, or oculoplastic surgeon for a consultation to determine what other treatments may help.

Daniel Levy, MD · Answer

The type of crease you describe is more likely due to a depletion of collagen and elastin rather than chronic muscle movements. Neither Botox nor surgery will build collagen, and the location of your crease is not suitable for filler, so I recommend fractionated CO2 laser resurfacing with Total FX.

Harold J. Kaplan, MD · Answer

Hi Littleton.  No, Botox cannot be used on the eyelid area and it's likely that if anyone tried the results would likely be very poor.

	If the wrinkles is caused by a heavy brow, then you may want to ask about a Botox browlift.  This may be able to help with the issue.

Toby Mayer, MD · Answer

You may benefit from a slight browlift at your hairline of in the hair, but it is not possible to decide without a photo of your problem.

Tom J. Pousti, MD · Answer

Thank you for the question.

	The area you described generally does not  respond well to Botox injection. It may actually cause drooping of the eyebrows or eyelids.

	Best wishes.

Joseph A. Eviatar, MD, FACS · Answer

BOTOX is a muscle relaxer. To the extent that any wrinkles around the eyelids are enhanced by closing or opening your eyes or squeezing your eyelids closed, BOTOX will help to soften those lines. And often, even vertical wrinkles will be softened by relaxing the muscle.

Vish Banthia, MD · Answer

Injecting Botox into the eyelid may cause lid droop, or ptosis -- a better method to instill skin tightening and minimize wrinkles involves the use of lasers. Laser resurfacing in the upper eyelid area (either fractionated or fully ablative) can dramatically improve / minimize wrinkles. I have had a good deal of success in tightening the upper and lower lid areas with the use of a combination ablative / fractionated laser (depending upon skin type) -- to the extent that the need for surgery is obviated in many cases.

Peter A. Aldea, MD · Answer

Botox works by weakening / paralyzing the muscles it is placed in. By carefully placing Botox in muscles whose sole function is creating facial expressions, we can "keep the good and take out the bad", removing frowning, lifting brows, opening angry tired eyes etc.

	Putting Botox into the leads will weaken the muscles which lift the eyelid open giving you a closed eye, zombie-meets-stroke look. Not something anyone would want to willingly create in a patient.

	Your best option is to have a laser peel - I prefer the Sciton Joule. It is an Erbium based platform that can match and outdo any machine in the world. It will smooth such wrinkles.

	Dr. Peter Aldea

Daniel Berg, MD · Answer

I echo the comments of others. In general Botox should not be used within the lid area unless for specific indications like eyelid spasm (blepharospasm). The muscles in the eyelid itself are needed for opening the eye and botox injections can easily weaken them leading to a droopy lid.

Enrique Pedro Gagliardi, MD, PhD · Answer

I  not recommend Botox in this area because is next the levator muscle of upper eyelid and could produce a ptosis.

	No recomiendo Botox en esa &aacute;rea porque es cercana al m&uacute;sculo elevador del p&aacute;rpado superior y se podr&iacute;a producir una ptosis.

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