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

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.

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.

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.