Will I Always Get a Droopy Eyelid when I Get Botox? Does It Continue?

I would like to know if I will get a droopy eyelid again if I try Botox for a second time. I got my first Botox treatment on October 20 and by November 1 I had a droopy eyelid. I would like to try Botox again even though I do not like the way my eye looks. I do like the way my forehead turned out. I received 32 units for my first time on my forehead and between my eyebrows. I did not have my entire forehead done.

Doctor Answers 17

Generally lasts for the duration of your Botox results

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It would be difficult to say if you'll always get droopy eyelid or not after a Botox treatment, but you should definitely discuss this with your injector if you'd like to have the treatment done again. They can reduce the dosage or try a different injection technique to reduce the risk of drooping. You may also want to seek a second opinion.

Will I alway get a droopy eyelid after Botox???

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A droopy eyelid is a known, but thankfully rare complication after Botox.  Since you liked how your forehead turned out, I would encourage you to get Botox again. 

However, I would encourage you to seek the services of an experienced injector.  I commonly get asked who should inject Botox.  I think the key lies in truly understanding the anatomy of the injected area, and more importantly the variability in the anatomy between patients -- for brows, the forehead and anywhere else you plan on receiving a Botox injection. This includes having a firm understanding of the origin, insertion, and action of each muscle that will be injected, the thickness of each muscle targeted, and the patient variability therein. As an aesthetic-trained plastic surgeon, I am intrinsically biased since I operate in the area for browlifts and facelifts, and have a unique perspective to the muscle anatomy since I commonly dissect under the skin and see the actual muscles themselves. For me, this helps guide where to inject and where not to. However, with that said, I know many Dermatologists who know the anatomy well despite not operating in that area, and get great results.

Good luck.

Once a droopy lid not always a droopy lid with Botox

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The forehead muscle is a strong lifter of the eyebrow / upper eyelid complex. If the forehead is relaxed by botox, then the aged forehead which has started to droop, won't be able to be kept up in position by the tone of the forehead.  Fortunately the treatment of the glabella in the forehead between the eyebrows, minimizes the strong depressor muscle function and this helps lift the forehead to compensate when treating the upper forehead wrinkles.  The same physician treating the same patient may find that one treatment causes a droop of the eyebrows when treating the forehead while all the other treatments did not.  This may be due to a slighlty lower position of placement along the forehead, or if the patient exerted themselves and bent over during the first few hours which might help spread the Botox to undesirable areas. Usually this occurs rarely and, of course, is self-limiting.

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

Botox and a droopy eyelid?

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Hi Jennifer.  You will likely only get a droopy eyelid if you go back to the same physician.  A droopy eyelid is a potential side effect of the treatment (it's happened twice in the last ten years at our practice) and should be very rare for experienced injectors.

We would recommend searching for another injector to avoid it.

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

Droopy Upper eyelis after Botox

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You experienced a droopy eyelid after Botox injections  because the material got into a small muscle of the upper lid; but don't worry, this is temporary. This may last another 9-12 weeks, but recovery may be accelerated by using Iopidine drops in the eye on the affected side. Because this is very rare, I recommend you continue with Botox injections in the future.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 43 reviews

Droopy eyelid after Botox

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It is likely that Botox injections to the forehead, rather than between the eyebrows, caused the droopy eyelid.  This problem is likely to improve in the next 3-4 weeks.  I would bring this minor complication to the attention to whomever treats you with Botox in the future so that the number of units to the forehead can be reduced to decrease the risk of a droopy eyelid.

Bryan K. Chen, MD
San Diego Dermatologist

Droopy eyelids can occur after Botox

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If both eyelids were effected then it is possible that you have too much "extra" skin over your eyes and you may not be a candidate for Botox in your forehead.  It is also possible that next time if Botox is injected higher in your forehead you can avoid this complication.  Without seeing a photo of you, it is difficult to know.  The effects of Botox will go away in a few months and you can get a consultation with an experienced injector to determine if you are a candidate.

Beginner's Luck?

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Wow, what a disappointment for your first treatment! This complication happens, but very rarely and often in women with thin skin and very little fat. Sometimes diminishing the dose and being sure to inject into the muscle helps to avoid this complication. Make sure that if you do try a new injector that you mention this complication. In our practice, we will provide a complimentary treatment to the patient as a way of saying "we want an opportunity to gain back your trust!" Good luck with your next treatment!

Best Regards,


Kirk A. Churukian, MD
Los Gatos Plastic Surgeon
5.0 out of 5 stars 6 reviews

Droopy brow?

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If botox is injected too low on the forehead, then a droopy eyebrow can occur. If the eyelid is low, then it was injected too low and will take a few months to get better.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Will I Always Get a Droopy Eyelid when I Get Botox? Does It Continue?

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 I have used neurotoxins like Botox, Dysport and the newer Xeomin for over 2 decades to reduce unwanted lines and wrinkles of the face.  IMHO, the droopy eyelid is from having the Botox, injected in the forehead, too close to the eyebrows.  In order to prevent the eyebrows from drooping (which makes the upper eyekids droop), I stay 1 to 1 1/2 fingerwidths above the eyebrows when injecting any of the toxins in the forehead.  The effects of any, of the neurotoxins, peak at 3-7 days which means the drooping shouldn't get worse.

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.