What can be done to correct a drooping eyelid five months after Botox injections?

Question

My plastic surgeon injected Botox under both of my eyes about 5 months ago for under eye bags. About 2 weeks later I had severe drooping of the lip and upper eyelid on one side. The lip is almost 100% now but the eyelid is still drooping slightly. So far I've done nothing but wait it out. Will apraclonidine eyedrops or any other exercise or treatment help at this point, or is this my new look for good?

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

No, this is not your new look for good...The good news is that this is not likely to be permanent. It WILL get better.  It typically takes 3-4 months for the effects of the Botox to wear off.  And typically, the eyelid droop typically lasts shorter because the full Botox dose doesn't usually diffuse into the muscle that elevates the eyelid.  Just to be safe, I would talk to a Neurologist to make sure there is nothing else going on...Massaging or exercise will not help at this point.  However, the droopy eyelid can be treated with Apraclonidine eye drops that may raise your eyelid up to 2mm. Be sure your prescribing physician discusses all the potential side-effects of the drops, such as "adrenaline-like" symptoms like anxiety or heart pounding; you may also experience eye irritation, eye dryness, and eye pain, amongst other symptoms. If these symptoms occur, you will likely need to take some lubricating eye drops, lower the dose, switch the eye-drops, or stop the drops altogether...Good luck.

Michael M. Kim, MD · Answer

Hello LynnT,Apraclonidine drops can help elevate the lid a few millimeters. It works by stimulating the inner lid elevating muscle called the Muller's muscle. It can essentially "buy time" until the Botox's effects on the lid have worn off. Typically Botox-related ptosis does not last as long as the usual 3-4 months since it is not directly injected there and is likely due to leakage of the product to affect one of the lid muscles.In sum, it isn't your "new look" for good. It will take some patience but it can be helped with the administration of these drops. Take care.Michael M. Kim, MD

What can be done to correct a drooping eyelid five months after Botox injections?

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What can be done to correct a drooping eyelid five months after Botox injections?

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