Is Botox for the eyelid a good or bad idea?

How Often Does a Drooping Eyelid Occur from a Botox Injection?

Doctor Answers 17

Can Botox Improve Eyelid Droop?

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
If you are referring to Botox treatment to improve eyelid droop, I would recommend that you see a very experienced physician injector. 

His/her goal would be to paralyze some of the depressors around the eye to elevate the brow a little, and perhaps raise the drooping eyelid.  This may be accomplished by (1) injecting between the brows (at the glabella) and perhaps raising the inside part of the eyelid some as the brow is raised, and (2) injecting the eye muscle (orbicularis) on the outside corner of the eye, hoping to raise the outside part of the brow and achieving some improvement of the eyelid in that area.

You can also treat the eyelid with Apraclonidine (or similar) eye-drops.

Regardless, be sure to get a thorough exam from your physician to evaluate the etiology of the droop and the necessary treatment.  Also be sure that all the potential side-effects of the eye-drops are discussed.

Good luck.

Drooping eyelid from Botox

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

The way in which an upper eyelid is addressed by Botox injections is to treat the glabella muscles and other depressor muscles of the forehead to help lift the eyebrows which in turn, can elevate the upper eyelid in some patients. There is no direct treatment of the upper eyelid with Botox.

Reasons why an upper eyelid might fall down...

1. if the forehead is treated in a patient that already has sagging of the forehead and has to constantly use the muscle elevation of the forehead to keep the eyebrow and upper eyelid loose skin up. By treating the forehead in these patients, there is a risk that the eyebrow and eyelid will fall down. Applying eyeshadow becomes difficult.

2. if the Botox is injected too low on the forehead in the line above the pupil, then Botox could diffuse into that area and the levator muscle becomes relaxed and there is a true ptosis or droop of the eyelid which can interfere with the upper field of vision.

Ronald Shelton, MD
Manhattan Dermatologic Surgeon
4.9 out of 5 stars 39 reviews

Botox for eyelid is a bad idea

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
Botox should not be injected in the eyelid. It can be used to lift the brow laterally to show more of the eyelid crease. This can be done easily by providers who know the anatomy and interactions of the muscles.

Kyle S. Choe, MD
Virginia Beach Facial Plastic Surgeon
4.6 out of 5 stars 42 reviews

You might also like...

Botox is not for the eyelid

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Botox is never used on the eyelid.  Dropping eyelid, although rare, can occur which is why it is important to see an expert injector.

Mitchel P. Goldman, MD
San Diego Dermatologic Surgeon
4.9 out of 5 stars 26 reviews

Botox and Eyelid Drooping

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

The possibility of an eyelid drooping after Botox is extremely rare (1%) if you go to an experienced injector.  This occurs when treatment is done for the frown lines.  This is not a risk when treating the crow's feet area.

Lori Stetler, MD
Dallas Dermatologic Surgeon

Botox for the eyelids

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Excellent feedback from panel members with a few interesting side notes worth commenting on.  Although off topic, it's worth pointing out that a good and safe Botox treatment doesn't necessarily mean shopping for the cheapest price.  When a practice is advertising very cheap prices compared to what is standard and customary, one must consider where the product is being purchased from or what the product actually is.  We all understand the need to seek the best value for aesthetic treatments; however, the "value" should be placed on the final outcome and integrity of the practice vs. pricing alone.  When standard pricing is well below what is considered customary, the consumer should consider whether or not this is a black market product or substandard treatment.  Purchasing Botox from outside of the US to use in the US is illegal and compromises the medical license of those doing so.

The second good comment previously made was that a "drooping eyelid" may be related to treating the forehead with too much product or placing the product too low on the forehead (aka: dropped brow).  The other cause may be related to migration of the product or improper placement around the eye area which leads to a drooping eyelid (aka:  ptosis).  Even the most experienced injectors may have an unintended outcome - although it should be very uncommon when one is experienced, skilled, and provides patients with detailed after care instructions.

In summary, using Botox or Dysport to key facial muscles leads to a very natural and satisfying outcome to the eyes as well as a natural "brow lift." 

Harold J. Kaplan, MD
Los Angeles Facial Plastic Surgeon
4.4 out of 5 stars 7 reviews

Drooping eyelid can result from Botox but this is temporary and RARE (with an experienced injector)

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

A drooping eyelid can result from Botox but this is temporary and RARE (with an experienced injector). A thorough understanding of facial anatomy and use of Botox make this complication very uncommon. There are no guarantees in aesthetic medicine but an experienced injector can give you the best shot at a great result without any complications.

Thank you for your question.

Stephen Weber MD, FACS

Botox is not for eyelids

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Anyone can inject Botox or Dysport but doing it safely and correctly requires a comprehensive understanding of functional anatomy to maximize outcomes. Each patient needs to be thoroughly assessed and have a specific treatment plan developed based on patient desires and a comprehensive aesthetic evaluation. It is as much an art as it is a science. And there is no substitute for experience. Choose your physician injector carefully.


Mitchell Schwartz, MD
South Burlington Dermatologic Surgeon
4.4 out of 5 stars 13 reviews

Droopy eyelid post Botox

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

I almost never see a droopy upper eyelid after Botox injections.  In fact, I cannot remember the last time that this occurred in my practice.   Brow ptosis (lowering of the brow) is a different story.  It is relatively easy to cause a brow ptosis if one injects too much Botox into the forehead and relaxes the brows elevators too much.  I treat the forehead in a conservative manner to avoid any risk of brow ptosis.  I tell my patients that I can always put more in, but I cannot take out what I have put in. 

Richard Ort, MD
Lone Tree Dermatologic Surgeon
5.0 out of 5 stars 28 reviews

Is Botox for the eyelid a good or bad idea?

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

I have used Botox to soften unwanted lines and wrinkles for over 20 years and I'm not sure what you're trying to accomplish with the Botox?  Upper eyelids, should not be injected with Botox IMO.  If you have fine lines and wrinkles of the lower eyelids, Botox can be injected but the eyelid muscles. once weakened by the Botox, may cause the lower eyelid(s) to sag and remain in that position for 3-4 months. For that reason, I typically will do a lower eyelid chemical instead to treat this area.

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.7 out of 5 stars 28 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.