Should Botox make eyelids heavy? (Photo)

The last two times I've gotten Botox my eyelids become heavy. My injector said it's because I get it in my forehead and it pushes the face down, so to speak. I like the results of the smoothed out forehead but don't like the heavy eyelids or extra skin it seems to produce. Is this normal?

Doctor Answers 21

Heavy eyebrow after Botox to the forehead

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Hi there,

Thank you for sharing your question - this is a great and very common question! 

The short answer is: you can treat the forehead with botox and stil get good brow position, particularly when you are younger.

The more detail answer is: the position of the brow is a balance between the muscles that elevate the brow and muscles that depress the brow. The forehead has the muscles that elevate the brow. It you paralyze the whole forehead, you won't have the action of those muscles.  Tricks that can be done are using a lower dose (so you weaken but not paralyze the muscle) and concentrating on the forehead muscles in the center of the forehead and using less Botox in the lateral portion of the forehead hence  allowing some movement in the tail of the brow (so you still have elevation in that area).

hope this helps! 

Portland Facial Plastic Surgeon
5.0 out of 5 stars 12 reviews

Eyelids heavy after Botox

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Sometimes the lids can appear heavy if your entire forehead is frozen from the Botox.  Having treatment in the middle of the forehead and preserving some movement can help make the lids look less heavy.

Jean Keamy, MD
Westborough Ophthalmologist
5.0 out of 5 stars 8 reviews

Heavy lids

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It is likely that your frontal muscle is weakened enough that it is not suspending the brow.  The brow will look flattened or feel heavy if this occurs.  You may have this issue, and if so, less botox-paralysis of the frontalis in the forehead will hopefully avoid it next time.  Of course, you may see more wrinkles in your forehead with less botox, so you might to have decide what you are willing to trade off.

Jeffrey D. Wagner, MD
Indianapolis Plastic Surgeon
4.9 out of 5 stars 30 reviews

Heavy Eyelids

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Thank you for your question.

Some patients do notice the "heavy" feeling you are describing, after treatment. It is not unusual for this to last for a few days. You may require a lower dose in specific areas. I'd recommend booking a follow-up appointment with your qualified injector to discuss your concerns and options. 

Take care.

Botox and Smooth Forehead and Heavy Eyelids

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It is really important to have Botox by an experienced injector.  You can smooth the forehead with Botox but you have to be experienced to know that it will pull down the forehead and cause your eyelids to be heavy. In these cases you are best having your glabella treated and "baby Botox" used in the forehead to avoid this.  Please consult an experienced Botox injector for the best cosmetic results.  Best, Dr. Green

Heavy eyelids after Botox for wrinkles

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Yes, Botox (or Dysport,Xeomin) treatments can make the upper eyelids or brow heavy.

While several muscles around the eyelids pull the eyebrow downward, only one muscle pulls the eyebrow up. Specialized techniques with Botox might be able to smooth the forehead, while maintaining or slightly elevating the eyebrow. Botox treatments are a balance opposing forces while relaxing wrinkles. Modifying the dose and/or treatment area might be able to achieve desired results. Lastly, upper eyelid heaviness might benefit from eyelid and/or brow lift surgery for appropriate patients.

Dr. Chaboki

Houtan Chaboki, MD
Washington DC Facial Plastic Surgeon
4.9 out of 5 stars 89 reviews

Botox effects

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Yes,if you had the forehead injected to smooth the horizontal wrinkles the botox weakens the frontalis muscle pull.The frontalis is the main muscle that elevates the brow,so since it is not working after the botox, the brow can come done and make the upper lids seem heavier.So it is a known effect that can be normally expected to happen in some cases depending on the details of amount and location of the injections

Robert Savage, MD (retired)
Wellesley Plastic Surgeon

Does Botox cause lids & brows to feel heavier?

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Botox and other drugs  like it (Dysport, Xeomin) are very useful and popular for relaxing overactive brows, forehead muscles and softening unwanted wrinkles. But sometimes muscles can be very sensitive to Botox and the forehead and brows may feel too 'heavy'. If the dose is a bit too high, brows can even droop. (not desirable!).  Each patient will respond to a dose of Botox in their own way: some patients require slightly higher doses and others lower doses. So the ideal treatment for each individual patient means carefully adjusting the dose to just the right amount and this may require a couple of sessions to find this out.   Remember: it is easier to add Botox but impossible to remove it!  :)

Donn R. Chatham, MD
Louisville Facial Plastic Surgeon
5.0 out of 5 stars 75 reviews

Should Botox make eyelids heavy?

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 Hi, I have used Botox and or one of the other neurotoxins for over 30 years.  If the frontalis and orbicularis muscles are injected within 2 finger widths above the eyebrows, the brows can drop.  It's important, IMHO, to avoid this area and place the Botox higher above the eyebrows.  

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.7 out of 5 stars 28 reviews

Heavy eyelids after Botox

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If Botox is administered with proper technique, in the appropriate locations with the correct dosage and amount of Botox you should not experience heavy eyelids. My suggestions is to consult with a board certified plastic surgeon to ensure you get the best results.

Mennen T. Gallas, MD
Katy Plastic Surgeon

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.