Inner eyelid drop 5 days after Botox

Question

Hi I had Botox for the second time 5 days ago, it seems my inner eye lid has dropped or brow? Will this correct itself? I rang my provider and they said to wait out the full two weeks as this could be temporary until full effects of the Botox has occurred. My first round I only got crows feet and forehead lines but this time I also got frown linesThanks

Leslie G. Branch, MD · Answer

This can definitely happen after botox if it migrated down and affected the muscles in your eyelid. Depending on the muscle affected, your eyelid may be lower but still able to open and close similar to the other side. Unfortunately there is not much you can do except wait it out. Usually 3 months before the botox starts to wear off. You can inject the other side for symmetry but I would not recommend this with the eyelids.

Shirat Ling, DO · Answer

Hello Alana.  There are a few factors that can lead to dropping of the inner eye lid after botox to the glabella (for the angry 11's / frown lines). The nerve that enables you to open your upper eyelid is located just under your eyebrow...this distance is different on different people, depending on your structure, how deeply your eyes are set, etc. Generally, we try to avoid injecting less than 1 cm above the brow bone, as botox can trickle down and affect that nerve, thereby reducing the ability to open your eye widely. It could also have been placed properly, but if you massaged the area, laid down within 3 hours, or exercised within 24 hours of the injection, it could have spread past the usual 1 cm spread from the injection site to the nerve. The botox could also have been reconstituted with greater dilution, which also causes more spread of the botox. I've seen this happen when an unauthorized injector decides to steal some botox from their office, dilute it, and use it at botox parties (so beware of these situations). You may want to ask your injector how they reconstitute their botox (as prescribed by Allergan versus more or less concentrated), and which type of botox they used. Dysport (another form of botulinum toxin) tends to spread more than Botox or Xeomin, even if reconstituted at the same concentration. 
In any case, you may improve the strength of that weakened muscle by using Naphcon A drops (OTC for allergies, at Walgreens) a couple times a day, or the physician at your medspa can prescribe another medication. It will improve, but not completely...eventually, the botox will wear off at the usual time 3-4 months later, and it will recover. And the person at the office is correct that we wait the full two weeks to see the full effect from the initial injection. 
If your entire brow is lower, and you cannot raise the brow itself, that is due to improper injection of the frontalis (forehead) muscle, which is the only muscle that holds the brows up...so either too many units, or injections too close to the brow. Unfortunately, attempting a botox brow-lift works only on the outer eyebrows and will not help the first type of eyelid dropping. 
I hope this helps...and best of luck with future injections.

Adrienne E. Stewart, MD · Answer

Hello Lisa, your question is difficult to answer without an examination or at least a photograph. Most Botox issues will certainly resolve themselves when the Botox wears off, usually 3 to 6 months. Your question brings up a really important point however, you should be much more concerned with the skill of the doctor injecting your Botox than with the price of the Botox. Many clinics which offer cut-rate deals on Botox have very inexperienced injectors. I would seek out a board-certified dermatologist, oculoplastic surgeon,or plastic surgeon to analyze your situation and perhaps treat you in the future. Adrienne Stewart MD FAAD

Pedram Imani, FRACS, MS, MBBS (Hons) · Answer

It's unclear as to what you are describing is ptosis (upper eyelid drop - inability to fully lift the eyelid) or brow ptosis (inability or partial ability to lift the brow).  Either is usually due to incorrect injection technique or too much Botox injection and spread to to the surrounding muscles.  If you have lid ptosis (upper eyelid), it may correct in 2-6 weeks or occasionally longer.  Brow ptosis, may last 3-4 months.  In general, if expertly injected these problems are avoidable, but the good news is even the most severe side effect will correct in 3-4 months.  Hope this is helpful.

Leonard Grossman, MD · Answer

If the condition you're seeing was indeed caused by a treatment with botox, then this will resolve over the next 2 to 4 months by itself. Good luck from New York City

Justin Harper, MD - Account Suspended · Answer

Hello alanacharlotte,
You are correct, two things are indeed possible: brow drop or eyelid heaviness. However, it would have helped if you sent a photo (pre and post). The face is not completely symmetrical so some injection points may not be exactly the same for both sides of the face. There is also a chance that the Botox reached the levator muscle of the eyelid (hence, opposing its action of elevating the eyelid) Regardless, on your touch-up your doctor can inject a small amount to muscles that are pulling the forehead down to minimize the brow drop.
Hopefully, the droop has resolved since the time you wrote RealSelf, but if it hasn't, rest assured that it will diminish within a month or two. it probably won't go the full 3-4 months.
I hope this makes you feel better, 
Justin Harper, M.D.

Inner eyelid drop 5 days after Botox

Answers (6)

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