Will the Effect of Botox Slowing Down the Lymphatic Flow Go Away? I Have Swelling on Lids.

Question

I had a botox injection directly under my lower eyelid and around eyes. 7 units on each side. They said that wasn't much. 6 days post-botox, I wake up with swollen eyes. They tend to go down and get a bit wrinkly until about early evening when they return pretty much to normal. Research shows that maybe it had slowed down the normal lymphatic flow, causing edema in the lids. Will this go away? I didn't realize this could happen and it is freaking me out that it will not return to normal.

Ron Shelton, MD · Answer

Botox relaxes muscles.  The eyelid muscle is injected on the side of the eye to decrease Crow's feet lines.  Occasionally doctors inject the lower eyelid skin to minimize creases or enlarged muscle bulges, but then the muscle action of the pump of the dermal fluids is inhibited or decreased.  Fluids can build up, especially when someone is lying down rather than sitting or standing. Lying down increases the blood pressure in the head and fluids leak into the dermis from the blood and lymphatic vessels.  During the day as you're up and around, the fluids drain better by gravity.  As the Botox's effect diminishes on its own over three to four months, the action resolves completely.

Harold J. Kaplan, MD · Answer

As discussed, what you are observing may actually be something other than swelling.  Although the effects will gradually wear off as the Botox does, we would encourage you to have an in-person discussion with your injector so that your concerns and treatment outcomes may be addressed and documented.

	We do not inject Botox or Dysport in this area for this very reason.  However, in the future, you may want to consider having dermal fillers (Restylane) in the tear trough area for eye rejuvenation.

Kenneth D. Steinsapir, MD · Answer

Kim

	There is absolutely no real research regarding how BOTOX might affect lymphatic flow in the eyelids.  There are about 30 papers out there on eyelid lymphatics and precisely none of them address this issue.  So as an eyelid expert, let me state that changes in the lymphatics due to BOTOX is at best an unsubstantiated theory.  In fact, it may have nothing to do with why eye eyelids can swell after being treated with BOTOX.  In particular, the etiology of the festoon is laxity of the orbitomalar ligament along the orbitomalar groove.  Any weakness in the orbicularis oculi muscle will induce the appearance of a festoon that has nothing to do with fluid under the skin or in the lymphatics.  As the BOTOX wears off, the muscle regains strength.

Robert Brueck, MD · Answer

This is an area that you have to be evry careful with.i usually don't do botox under the eyes.the good news is that it will eventually wear off.

Steven Hacker, MD · Answer

Swelling of the lids after Botox may occur for a variety of lesions including the trauma of the procedure. In any case all of these effects are temporary and uncommon.

Will the Effect of Botox Slowing Down the Lymphatic Flow Go Away? I Have Swelling on Lids.

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Will the Effect of Botox Slowing Down the Lymphatic Flow Go Away? I Have Swelling on Lids.

Answers (9)

Answer: Botox under eys

Answer: Botox under eys

Answer: Swelling of the lids after Botox

Answer: Swelling of the lids after Botox

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Recommended reading

Everything you need to know about Botox

Our mission is to create a world where every investment in modern beauty is Worth It.