Is It Possible to Get Droopy Eye Lids Right After Botox Wears Off?

What you're likely experiencing is a droopy eye-BROW with skin gathering over the eyelid to mimic a droopy eye-LID.   This is likely due to the Frontalis muscle in the forehead that normally elevates the brow to still be paralyzed by the Botox, causing a bit of a brow droop... Give it some more time, and as the Botox wears off in the Frontalis, the asymmetry and droop should both improve...Good luck.Dr Markarian

Depending on the time course of your first and last botox injections, as the glabellar botox (between the eyebrows) has vanished, the lifting effect of the glabella is now gone and possibly the more recent secondary adjustment injections near the eyebrow which can lower the eyebrow, are still active and lowering them. Your doctor may be able to utilize all the different injections you've had and do the next treatment with these insertion sites so you get longevity of the full benefit of all areas treated and they wear off together.

As the Botox gradually wears off (key word being "gradual"), it would not be likely that what you are now seeing is linked to the Botox treatment four months prior.  As panel members suggested, you may be more aware of the heaviness of the lid because the Botox was improving this area.

In our practice, we take before/after photos to better assist practitioner and patient on their assessment.  We encourage you to discuss your question/concerns with your injector for feedback.

 

Botox should not create any permanent ptosis.  If you had multiple injections over time some of the botox maybe  still present.  You need to let all of the botox wear off which should occur 3-4 months after your most recent injection.  Often patients who develop ptosis or eye lid droop from botox may actually have had preexisting mild ptosis which they compensated for by lifting their brow.  You should have your Dr Assess your eyelids after all botox has worn off.  I suspect you may have preexisting mild ptosis.

The botox that was injected several months ago to your glabella and lateral brow gave you a brow lift.  When botox wears off (usually takes 3-5 months), your skin will return to its starting position.  Botox has no permanent effect. 

But, remember, Botox does not wear off abruptly.  It wears off gradually.  I suspect that the reason why you are noticing more droop on the right is that most of the botox has worn off on the right, but there is some residual botox effect on the left.  Over the next several weeks, the botox on the left side will wear off as well, and your lids will return to the shape that you had prior to any injections. 

The only other thing to consider is whether you have had a stroke.  This can lead to asymmetric facial features.  But given your history and the focality of the defect (R eyelid droop), I think that your symptoms are likely due to the botox wearing off. 

I would recommend you return to you injecting physician and let them assess you.  Hopefully your doctor obtained photographs prior to treatment.  If not, determining precisely what is going on will be more challenging.  

I highly suspect you had the heavy upper eyelids prior to your Botox treatment, the Botox gave you a brow lift which cleaned up the redundant skin in your upper eyelids, and then when it wore off your eyebrows went back down and the redundant skin returned.

There is definitely no way that Botox wearing off would cause such a condition if it did not exist prior to getting the treatment.

As you mentioned, you had touch ups to adjust the shape of your eyebrows, this shaping in some part was the brows going up.  When the brows go up, the upper eyelids get cleaned up.

The results of the droopy eyelid should be seen with in the first two week of the injection due to effect on the eyelid levator muscles. At 4 months after the injections that is not due to the effects of the neuromodulator. If it persist consult your doctor for further evaluation.

 

Good luck !

Botox rarely causes eyelid drooping or ptosis.  When it does, it is apparent at the onset of Botox effect (within 1-2 weeks).  If you noticed it after 4 months, it is unlikely it is related to the Botox.  If you had any baseline photos taken prior to the injection, it may be helpful to take a look at those.  Sometimes the Botox can mask "imperfections" that you did not notice before, and once the Botox wears off, they become more noticeable.  If the eyelid drooping is truly new, you may wish to discuss it with the treating physician.  Botox can be injected into the upper eyelid to decrease the drooping, or you may want to get an evaluation for excessive lid reduction surgery or blepharoplasty.

When Botox (or other neurotoxins) are injected properly by a well-trained, board-certified dermatologist or facial plastic surgeon, droopy eyelids can and should be avoided.  However, if it happens, it is usually because the neurotoxin was injected too close to the eyebrow and/or too much was injected.  Droopy eyelids secondary to a lowered eyebrow are usually seen within 1 to 2 weeks of the treatments and typically wear off as the neurotoxin wears off.  There are also in-office treatments that can help improve a droopy eyelid.  You mention developing a so-called droopy right eyelid four months after having received the injections and as the results of the neurotoxin seemed to be wearing off.  I honestly cannot explain that based on what you have shared, but would be surprised if it is related to the Botox originally injected. That being said, I recommend you consult with the physician who did the treatment for you for evaluation and discussion of possible causes and if necessary, possible treatments.  Hope this helps. Good luck!