Creases on eyelid after botox. Can it be fixed? (Photo)

Question

Hi. I've recently had botox on my forehead, crows feet and between brows. One arch is slightly higher than the other but more worrying is that this lid has now developed deep creases. Botox doctor has told me it has nothing to do with the botox but it wasn't like this before. Can this be fixed?

Steven F. Weiner, MD · Answer

This is probably a combination of the forehead injection and crows feet injection. There is some hyper mobility of the orbicularis oculi in the upper lateral area which is compensatory hyperactive. Perhaps some additional Botox there would help. Also, it could be related to the frontalis muscle relaxation causing slight droop of the eyebrow, making apparent some pre-existing problem with the upper eyelid. Doing nothing, this should all return to normal in a few months.

Melvin Elson, MD · Answer

This sometimes happens after muscles around an area are weakened and the other muscles compensate. this is temporary of course as Botox wears off. if you have it done again have the doctor try not to go so close to the lid when injecting and be sure you see a board certified dermatologist of plastic surgeon

Edwin Ishoo, MD · Answer

There are no close up before pictures for proper comparison evaluation. If you believe that the upper lid wrinkles are related to the Botox treatment, then they will return to normal in 3-4 months once the Botox wears off and there is no need to"fix" this.

Michele S. Green, MD · Answer

It sounds as if from the Botox injected into the forehead you developed these eyelid wrinkles.  This can happen often when there is some extra skin above the eyelids and then the wrinkles develop.  You may not be a good candidate for Botox in this area or need an upper eye lift.  Please consult an expert.  Best, Dr. Green

T.G. Khan, DO, FACS · Answer

The reason you have a crease is because the brow was lifted from the Botox procedure. It can be corrected with some SMALL additional amounts of Botox to relax the lift but it has to be done VERY carefully as to not drop the brow.

Steven Swengel, MD · Answer

The pictures are so closeup it is hard to discern what is actually happening.  My best guess would be that you have some lateral recruitment of the forhead muscle(frontalis) above that particular brow, causing some extra arch to the brow and some folding/pleating of the lax upper eyelid skin.   It may indicate time for a bleph, a brow lift, a possible tightening or resurfacing of the periorbital skin.   One can always correct an overly arched brow, but I have seen in my practice that once this 'spocking' starts occuring, one either has to stop placing Botox in the forhead, reduce the amount of Botox or start talking about other options rather than relying on neurotoxins only.

Elliot Duboys, MD, FACS (retired) · Answer

Is it that the arch of one eyebrow is higher or the other is lower?  Depends upon where (anatomically) you had the botox injected.  If you received botox to your forehead, there is a possibility that you have a droopy eyelid - a known complication.  However, if you received botox around your eye (in the crow's feet area), - this is where botox is injected to raise the eyebrows, you might not have received the same dosage on each side.  Speak to your doctor.  Unfortunately, the photographs are inadequate in that they don't show both eyes at the same time.

Creases on eyelid after botox. Can it be fixed? (Photo)

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