What to Expect for First Time Botox Injection?

Should I be concerned about first time Botox on frown lines? Lots of testimonies re: droopy eyelids.

Doctor Answers 7

The importance of a skilled Botox injector.

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I can't stress enough the importance of seeking out an injector with skill and experience. I recommend limiting the search to board certified Plastic Surgeons and Dermatologists. Be wary of anyone who gives injections 'on the side'. You want an injector who has studied facial anatomy and will customize your injections to your face. An inexperienced injector may inject too much, or they may inject into the wrong muscles. Just a millimeter off can make a world of a difference. Some of these complications from Botox being administered incorrectly by untrained injectors can be very serious, even life threatening. Do you really want to put your safety into the hands of someone who has learned to do Botox during a weekend class? Just because the procedure is less invasive than surgery it does not mean it should be rushed into without proper research and thought.


Kennewick Plastic Surgeon
4.5 out of 5 stars 18 reviews

First time BOTOX...

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Although it is important to know the risks and complications of any procedure, please recognize that eyelid droop is a known, but RARE complication of Botox.

My only recommendation would be for you to seek the services of an experienced physician injector.

I think the key with Botox 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.

Dr Markarian

Botox for the first time

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If you are treated by a board certified dermatologist or plastic surgeon who is an experienced injector, it is rare to have a droopy eyelid.  Your injector will ask you to frown and watch for the muscle movement.  This way the Botox can be injected into the exact areas where needed to stop your frown.  You will love it!

Martie Gidon, MD, FRCPC
Toronto Dermatologist

Botox side effects are rare.

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 In order to get the best results and minimize side effects just make sure you are having your Botox treatment done by an experienced injector. The eyelid drooping you are worried about is a rare side effect of treating this area and can be minimized by proper injection technique. 

Patricia Farris, MD
Metairie Dermatologic Surgeon

Droopy eyelids after Botox not common anymore

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Injected properly and by experienced physician drooping of the eye lids following Botox have become a rare side effects.

Over the years, we have learned where the danger zones are and if the injector stays away from thes areas, your eyelids will not droop.

Nissan Pilest, MD
Irvine Dermatologic Surgeon
4.6 out of 5 stars 23 reviews

Droopy eyelids are more common with combination therapy

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There are many different ways of injecting Botox. You should see someone who is very experienced in its use. When treating the frown lines between the eyebrows, often referred to as the number “11” when they are present as two lines, one rarely sees droopy eyelids. This can happen when the forehead is treated at the same time and the muscle no longer keeps the eyebrows up and they fall. There is a standard area that experienced Botox injectors avoid over the eybrow so this doesn’t happen.

Ronald Shelton, MD
Manhattan Dermatologic Surgeon
4.9 out of 5 stars 38 reviews

Droopy Eyelids Pretty Rare

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Yes, judging by these postings you probably think that droopy eyelids happen all the time. In experienced hands this side effect is actually quite unusual. Make sure you see a physician who has been using Botox for a number of years. Do not ask for anything complicated, just standard Botox injections and I am pretty sure you will not have a problem.

Arnold R. Oppenheim, MD
Virginia Beach Dermatologist

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.