Eyelid Ptosis From Botox?

I had botox 1 yr ago and still am experiencing weakened eye muscle. On awakening I feel a struggle to open my lid. My eye always feels fatigued. Are there o/c drops that will help or eye exercises I can do. Have you heard of this problem lasting this long?

Doctor Answers 12

Not for this long after

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The results of your treatment should have worn off by now so I suggest you visit an oculoplastic surgeon for an assessment. Best of luck.

Botox doesn't last a year so an eyelid droop is probably not a complication of botox

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The Botox effect is usually completely removed by 4 to 5 months, rarely six but I have never heard or read of it lasting more than six months. Sometimes people are able to train their muscles not to frown after the botox wears off and so they think their Botox is still working but when examined the muscles have full function if the person wishes to contract them.  Similarly, you might have used your forehead muscles to help lift up the eyebrow/eyelid area and after Botox, that activity might be subconsciously trained by you not to be as active and so the upper eyelid is hanging down more than you remember before Botox.  On the other hand, true ptosis or the upper eyelid which is related to a weakening of the levator muscle can be made more apparent by Botox administration, but the problem existed prior to the treatment but wasn't as noticeable. Please see an oculoplastic surgeon for a thorough evaluation of your condition.






The information provided in Dr. Shelton's answer is for educational purposes only and is not intended to constitute medical advice.  The information provided should not be relied upon as a substitute for consultations with a qualified health professional who may be familiar with your individual medical needs. If you are experiencing a medical emergency proceed to your nearest emergency room.


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

Botox Causing Eyelid Ptosis?

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The ptosis you are experiencing is not a result of Botox, since the effects of a Botox injection last no longer than 6 months. I advise you to see a neurologist or ophthalmologist immediately, as ptosis can be a symptom of serious illness.

Sanusi Umar, MD
Redondo Beach Dermatologic Surgeon
4.6 out of 5 stars 33 reviews

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Eyelid ptosis from Botox

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The effects of Botox will last an average of three months, sometimes more and sometimes less depending on the patient.  Ptosis, or drooping of the eyelid, can be a result of Botox injections even if they are performed properly, but it usually improves over a few weeks to months.  After one year, the effects of Botox are no longer present.There are many other causes of ptosis, and some of them can be serious.  I would recommend seeking the advice of an ophthalmologist to examine your eye.  Thanks and best of luck.

Droopy eyelid from Botox?

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Botox works by weakening muscles but the effects last 2-6 months.  Your eyelid droopiness is not from Botox that you received one year ago.  Recommend you see an ophthalmologist or oculolplastic surgeon.

Eyelid ptosis is not due to Botox at 1 year

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Thank you for your question.  A droopy eyelid (ptosis) is extremely rare after botox.  The fact is, if a patient has ptosis after botox, it is usually the case that the botox unmasks the ptosis that was there (but being compensated for by over active brow elevater muscles) and not appreciated by the patient.  This is the reason patients need to see specialists with extensive botox experience.   Their situation can be assessed pre-treatment and the ptosis avoided.  In the rare cases, of true botox induced ptosis, there is an eye drop (Iodipine 0.5%) that can be used and improve the situation.  Botox induce ptosis, even if untreated lasts only weeks.  You have ptosis that is unrelated to the botox but that was unmasked by the treatment.  Seek a surgical consultation for assessment and correction.  It is a straight forward operation when done by a surgeon who treats the condidtion on a regular basis.  

Scott Barr, MD
Sudbury Plastic Surgeon

Ptosis 1 Year After Botox- Not a Botox Problem

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If your Botox injection was a year ago, then the Botox is not your problem. Ptosis from an injection of Botox is a relatively rare complication, and while the Botox may take up to 6 months to wear off (although usually closer to 3 months), the ptosis (when it occurs as a sequelae of the injection) generally goes away much sooner (6 weeks on average). If you are still having problems with eye opening, then you likely had a pre-existing ptosis (pretty common), or happened to develop an unrelated ptosis in the meantime. There are also some rare eye muscle problems that could explain your ongoing problem. If things are not improving at all, it may make sense to see an opthalmologist to make sure that nothing more serious is going on.

Michael R. Menachof, MD
Greenwood Village Facial Plastic Surgeon
4.4 out of 5 stars 27 reviews

Eyelid Ptosis is from aging at this point, not Botox

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I would advise you to look at your pre-Botox photos. Many, many people have eyelid ptosis normally, before any procedures like Botox are ever done, and they don't realize it. Over time and as we age, ptosis can naturally just become worse. Many people in their 50s and up have to have surgery to resolve ptosis (NOT from Botox but just natural ptosis) because ultimately it can affect vision. It doesn't have to do with the Botox because it only lasts for 3-4 months in that area and your muscle will recover even if you do get worse ptosis from the Botox. This is simply ptosis from aging, and I'd seek a consultation with an ocular surgeon.

Botox and eyelid muscle weakness1 year post

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    The Botox which was placed one year ago is no longer present, 3 months is the average time for Botox to last.  If you are experiencing eye muscle weakness this needs to be evaluated by an ophthalmologist or occuloplastic surgeon.  Lana Long, M.D.

Lana Long, MD
Cincinnati Dermatologic Surgeon

Eyelid muscle weakness

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One year after Botox, a weakened eye muscle should be not related to the treatment. I recommend that you see a board certified oculoplastic surgeon or ophthalmologist to rule out another underlying reason for this problem. Best of luck.

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.