Botox Has Cause My Lower Eyelids to Sag, Will this Go Away Eventually?

Question

I was injected with botox on Sept 6 with 20 units around my crowsfeet & 4 of them were near the underneath of my outer eyes. Then I went back & got a touch up on Oct 4 cuz the Dr told me I had strong eye muscles. She injected me with 10 units around my crowsfeet and 6 units below my eyes on my eyelids, thats 3 units below each eye area. I now have terrible bags, I got them Oct 9. My lower eyelids have sagged causing the whites of my eyes to show & dry my eyes out. Scared the bags wont got away!!

Ron Shelton, MD · Answer

The bags may be from a lack of pump action on the eyelid muscle that was affected by the Botox in this off-label procedure. That is why we tend not to inject the lower eyelids of people that have intermittent puffiness around the lower eyelids.  Sometimes, though, patients don't mention or have this prior history and then the treatment is done and they develop the bags. they do go away in about three months, sometimes a little longer.

Harold J. Kaplan, MD · Answer

Hello.  While the situation seems pretty bad right now, you will recover well.  The effects of the Botox should wear off enough so that the bags start looking better after 6-8 weeks.  The effects should be fully gone by three months based on the amount of product that was injected.  

	To be frank, it does not sound as if your injector was doing you a favor in this area.  In the future, have your injector stick to the outer eye only as the closer you get to under the eye, the more likely it is that you will experience this problem.  Relaxing these muscles makes the fat that surrounds the eye more likely to pull (push) downward, creating the appearance that you have bags.  This is why most experienced injectors do not use Botox under the eyes.

Kenneth D. Steinsapir, MD · Answer

So sorry to hear about this.  Obviously, it is essential to get care with a physician who knows what they are doing.    I would strongly recommend seeing an ophthalmologist or an oculoplastic surgoen for dry eye management until the treatment wears off.  The American Society for Ophthalmic Plastic and Reconstructive Surgery maintains a geographic directory that will help you identify a highly qualified oculoplastic surgoen in your area (asoprs.org).

Michael L. Schwartz, MD · Answer

Sorry to hear you are having this problem, however this is one of the great benefits of botox and most fillers. They are not permanent and will go away and so will this problem. Keep that in mind when you are seeking other "permanent" treatments. In the meantime you should protect your eyes from exposure with lubricants and possibly taping them at nght.

Steven Wallach, MD · Answer

I do not use botox under the eyes for this very reason.  It weakens the lower lid tone and causes the eye to have an ectropion.  This will improve over the next few months.  You should check with your doctor about eyedrops to maintain moisture.

Botox Has Cause My Lower Eyelids to Sag, Will this Go Away Eventually?

Answers (10)

Answer: Eyelids drooping

Answer: Eyelids drooping

Answer: Botox under the eyes

Answer: Botox under the eyes

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Botox Has Cause My Lower Eyelids to Sag, Will this Go Away Eventually?

Answers (10)

Answer: Eyelids drooping

Answer: Eyelids drooping

Answer: Botox under the eyes

Answer: Botox under the eyes

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Recommended reading

Everything you need to know about Botox

Our mission is to create a world where every investment in modern beauty is Worth It.