Severe edema/swelling 4 months after Botox injections (Photo)

Thank you for sharing your question and photograph.  Unfortunately any effects from Botox should have fully resolved and other issues must be explored - for example any other product that may have been injected, allergic reaction, lymphatic drainage issues from the upper and lower blepharoplasty, etc.  I would work with your surgeon and an ocuplastic surgeon to determine what is causing this swelling.  

I recommend following up with your surgeon. At 4.5 months, this is unlikely due to the Botox. Hope this helps.