Eyelid drooping, Ptosis from Botox could it be permanent damage or some other problem after 12 weeks? (Photos)

Question

10 days after botox to brow area I noticed drooping right eye. I was/still am mortified! I called my injector and described the problem and was prescribed apraclonidine drops. It has worked well to lift my eyelid but does cause discomfort and irritation. It has been 12 weeks since my initial botox and my right eye is still droopy. Shouldn't botox be wearing off? Is there anything else I can do? Is it safe to be using the apraclonidine for 10+ weeks?

Stephanie Molden, MD · Answer

This can occur if the Botox is injected. A little too deep into the eye muscles or if too much is used in that area.  However, this should reverse itself.  In some people, Botox lasts longer than others so give it a little more time.  By 4 months I would be surprised if it isn't gone.

Faiyaaz Kalimullah, MD, FAAD · Answer

Thank you for your question and for submitting your photos.  I'm very sorry to hear that you're experiencing eyelid ptosis after your Botox treatment.  Eyelid ptosis occurs when Botox injected into in the glabella (the area between the eyebrows) drifts and affects the muscles that control the eyelid itself.  12 weeks is longer than I usually expect to see eyelid ptosis last - I think you should start to see improvement in your eyelid position within the next few weeks.  Until then, it should be safe to continue apraclonidine drops under the supervision of your physician.  I hope you feel better soon!

Sheryl D. Clark, MD, FAAD · Answer

Dear corall123:
I am so so sorry to hear you are having this problem. This is, indeed, from the Botox and 12 weeks is a long time to be suffering from this. It should wear off very soon. it is safe to continue the medication until this happens.
There are methods and tricks for preventing this from happening, so you should not be afraid to have another treatment in the future with an advanced injector. 
All the best, Dr. Clark

Alex Eshaghian, MD, PhD · Answer

Thank you for
your question corall123. I am sorry to hear about your situation. Botox is a
purified protein used to address wrinkles associated with facial expression. A rare complication of Botox is drooping of the eyelid which can be treated with apraclonidine. While this typically resolves in a few weeks it can last up to 3-4 months. It is safe to use this product for such a time period. Please
consult with a doctor for specific recommendations. Good luck!

Melvin Elson, MD · Answer

10 weeks after Botox you can still have drooping and the aproclonidine will continue to help.  This will not be permanent and will wear off even though this is longer than usual

Eyelid drooping, Ptosis from Botox could it be permanent damage or some other problem after 12 weeks? (Photos)

Answers (6)