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Posted under Botox q&a

Lower Lid Drooping and Wrinkling from Botox

PTC2009
I had a Botox treatment back on 9/11/2008 for crow's feet on both eyes. I saw some nice improvements to the lines in a week, butabout 6 weeks later I noticed that both lower lids became droopy, wrinkled, hollow-looking and physically felt tired. Every week that went by it got worse going from only having 1 wrinkle under each eye before treatment to now having 3-4. The lower lid skin now looks like leather (excess skin with no elasticity) and the orbital rim has lost its fat, making it look like a separation between the upper cheek bone and lower eye lid. After 4 months, the crow's feet returned and the lower lids still look horrible, even worse when I smile. It appears that my upper cheek bone has become raised, causing the uneven transition between the lower eye and cheek bone. When I slightly press on my upper cheek bone (where it is now raised), the orbital rim is filled in like it used to look before the injections. It seems, in my observation, that the fat in the orbital rim has dropped into to my upper cheek bones. One doctor said that it's not the Botox, just a coincidence and that I'm just aging. I find it hard to believe that I aged almost five years in my eyes in just 6 weeks. Another doctor said that it was the Botox injections, and that it should resolve itself in time. It’s not getting any worse now (except that the crow’s feet returned adding more wrinkles), but my lower lids look so bad after 5 months that a plastic surgeon recommended eye lid surgery. Before Botox, my eyes were perfectly fine, except for the crow’s feet. I’m 40 years old, but my eyes now make me look like I’m in my mid to upper 40’s. Please help me understand what has happened and if there is anything I can do to resolve this problem, or if it will, in fact, resolve itself.

Answers (5)

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Daniel Reichner, MD, FACS profile photo
Daniel Reichner, MD, FACS
Answered on Feb 19, 2009
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Dr. Daniel Reichner, MD, FACS
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David Shafer, MD, FACS
Answered on Feb 19, 2009
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Dr. David Shafer, MD, FACS
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Steven Wallach, MD
Answered on Nov 14, 2010
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Dr. Steven Wallach, MD
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Stephen A. Goldstein, MD
Answered on Mar 19, 2009
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Dr. Stephen A. Goldstein, MD
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Kenneth R. Francis, MD, FACS profile photo
Kenneth R. Francis, MD, FACS
Answered on Feb 23, 2009
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Dr. Kenneth R. Francis, MD, FACS
Board Certified Plastic Surgeon
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