Can Botox help with drooping eyelids?

Question

My eyelids sags a little so I look a bit tired. It isn't drastic however I want to look more alive and awake. Can botox help me look more awake? And what is the cost for botox treatment in NYC?

Houtan Chaboki, MD · Answer

Botox helps reduce wrinkles by relaxing facial muscles. Droopy eyelids may be due to excess or sagging skin, muscle, or fat. An eyelid lift or brow lift is the more common approach used by cosmetic surgeons to help treat droopy eyelids. Typically, Botox does not help with droopy eyelids. Botox has been used, however, to help raise the eyebrow a bit. Results are more subtle and temporary as compared to surgical facial procedures. However, Botox might improve your appearance to make you appear more awake and less tired. 

	Speak with a plastic surgeon or dermatology specialist to help determine appropriate options for you. Best of luck.

	Dr. Chaboki

Jonathan Kulbersh, MD · Answer

Well-placed Botox can lift the eyebrows. It will take 1-2 weeks for final results. I recommend getting a formal evaluation with a cosmetic dermatologist. Hope this helps.

Jerome Edelstein, MD · Answer

Drooping eyelids would probably be better addressed with an eyelid lift, which is a surgical procedure.

Mark K. Markarian, MD, MSPH, FACS · Answer

Short answer -- Botox is NOT likely to help with drooping eye-LIDs.A droopy eye-LID can have multiple causes. If the eye-LID droop is genetic or due to other neurological or mechanical causes, then you are best served by seeing a physician who treats eyelid droop (aka ptosis) regularly -- my recommendation would be to see an Oculoplastic Surgeon in that scenario.  A droopy eye-BROW can be treated with a Brow lift -- this can be performed by a Plastic Surgeon or Facial Plastic Surgeon.  A droopy eye-BROW can also sometimes be improved with Botox injected into the outside part of the eye (the lateral aspect of the orbicularis oculi muscle) to generate a bit of a brow lift in that area -- this is obviously a short-term solution.  Botox is less effective in treating a droopy eye-LID because the eye-BROW elevation from the Botox does not significantly improve they eye-LID droop...Be sure to seek the services of an experienced physician injector. I think the key with Botox lies in truly understanding the anatomy of the injected area, and more importantly the variability in the anatomy between patients -- for brows, the forehead, and anywhere else you plan on receiving a Botox injection. This includes having a firm understanding of the origin, insertion, and action of each muscle that will be injected, the thickness of each muscle targeted, and the patient variability therein. As an aesthetic-trained plastic surgeon, I am intrinsically biased since I operate in the area for browlifts and facelifts, and have a unique perspective to the muscle anatomy since I commonly dissect under the skin and see the actual muscles themselves. For me, this helps guide where to inject and where not to. However, with that said, I know many Dermatologists who know the anatomy well despite not operating in that area, and get great results.Good luck.Dr MarkarianGood luck.

Ron Shelton, MD · Answer

Some patients obtain good lifting of their upper eyelids by having botox injected into the lower mid forehead (the glabella) and the outer tail of the eyebrows as these muscles typically lower the area, so by relaxing the depressor muscles, the unopposed lifting action of the upper forehead muscle can raise the eyebrow/eyelid complex. 

	Please refer to the book I wrote on Botox, published by Penguin Putnam and available on Amazon.com  It is a very easy and quick read.

	 Sometimes, filler such as Restylane, placed in the eyebrow region can augment support of the eyebrow/eyelid tissues and help lift as well. The cost of botox depends on the number of units of Botox used, which is different for each patient depending on their anatomy, strength of muscle action, and also the doctor's skill. YOu can expect to pay several hundred dollars and the botox lasts for about three to four months.

Nelson Lee Novick, MD · Answer

Age-related loss in fat in and around the eyebrows, as well as photoaging-related losses in the quality and quantity of collagen and elastic fibers can lead to drooping, saggy brows and overhanging false eyelids (brow skin that hangs over the real upper eyelid below).  Botox, as well as Dysport and Xeomin (two other neuromodulators) when placed in tiny droplets under various areas of the eyebrows (differing places for men and women) can contribute to a slight lift of the brow that can help diminish sagging and droopiness.

	The addition of a volumizing filler, such as Juvederm Ultra XC, into specific regions of the eyebrows (men and women differ on where they may need volume resoration and recontouring) and of the adjacent temple region, can futher enhance the lifting effect of the Botox and also contribute to a much longer-lasting result. The wonderful fact is that the entire treatment can be done in about ten or fifteen minutes.

	Treating this region requires both medical expertise with the materials and an experienced esthetic eye. For this reason, you should consult with an injector that has done many of these procedures. Prices will vary according to the amounts of each material needed to achieve the desired results, but since small amounts are generally required, particularly of Botox, treatment usually fits most people's budgets and is quite gratifying.

Harold J. Kaplan, MD · Answer

As other panel members have discussed, this is something that is best evaluated with a physical exam. It is possible to lift the lateral brows a few millimeters with botox or dysport, which often provides beautiful results. Depending on the amount of correction needed, this can be an option. I suggest you contact an experienced injector near you to schedule a consult.

Monika Soni, MD · Answer

Thank you for your question. Botox may not be what you need and I am sure this not what you want. You may be able to make this better with fillers, but I think you are better off with surgery to tighten up your eyelid. I recommend having a consultation with an expert to discuss your concerns and to determine the best treatment plan for you. Best of Luck!

Richard Ort, MD · Answer

Botox can be used to give a subtle lift to the eyebrow, which can also help to raise the upper eyelid a bit.  For this injection, Botox is injected in low doses at the lateral tail of the eyebrow.  Botox injections in the glabella or between the brows can help raise the medial or central part of the eyebrow.  Another non-surgical approach would be to inject a filler such as Juvederm or Restylane into the lateral part of the eyebrow.  This helps to provide anterior projection of the brow and also provides a mild brow lift.

Fereydoon S. Mahjouri, MD · Answer

If your eyebrows are droopy and your upper eyelids are saggy because of droopiness of your eyebrows you may look tired or aged. In that case botox can elevate your eyebrows and the excess skin covering your lashes would be reduced to the point that the crease of the upper eyelids become more visible. The price of botox varies from state to state and cities to cities. It should not cost more than $15.00 per unit. You need to have at least 16 to 20 units of botox to achieve elevation of the eyebrows. I hope this is helpful to you.

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