Soppy one eye 8 days after Dysport (Photo)

Question

I received dyadport first time on top of my brow, crows feet and middle of my browns 8 days ago. I haven't noticed any drooping until TODAY. I have received Botox basically same areas for over 15 year. I had it done with a a very experienced plastics surgeon but it was the first time with his. I can't figure out why it happened so late, in one eye (the one he actually injected less), was it technique or the dysdport? Tryied both eye drops without improvement I was considering emergency eye surgery

Aldo Guerra, MD · Answer

You have levator dysfunction. This is a temporary issue and I don't believe anyone would operate on you based on your symptoms. Instead, there are drops which can be effective in raising the eyelid while Dysport wears off. Your Dysport migrated into the muscle that was raises the eyelid and was not injected directly. Typically, this causes the relaxation of this muscle to be short-lived. You should contact your injector, and as this is one of the most common issues after Botox and Dysport, they will know what to do. Otherwise, see an ophthalmologist.
Best wishes, Dr. ALDO :)

Peter N. Butler, MD, FACS · Answer

Hi there, sorry this happened. You did not notice this Dysport effect until today, because the product takes 7-10 days to be fully effective. The levator muscle was not directly injected, but some of the product migrated down causing ptosis (eyelid drop). It is likely only a small amount of product made it to the eyelid lifting muscle, so the effect will wear off faster than the remaining Dysport. There are eye drops which can be prescribed to make a small improvement, or you can try over the counter Visine.

Camille Cash, MD · Answer

I'm sorry you are experiencing a drooping lid.  Botox and Dysport are formulated a bit differently with Dysport sometimes being more diffuse which may have contributed to this outcome.  The effects are temporary and should notice improvement over time.

Summit Kundaria, MD · Answer

Thank you for the question and pictures.   Your Dysport migrated to the upper eyelid and is giving you elevator dysfunction, or eyelid ptosis.  There are eye drops (iopidine, for example) that can give you temporary relief until the effect wears off from the upper eyelid.  You should talk to your injector about this.  This complication can happen with any neurotoxin used, and is not specific to Dysport, and it is related to placement/migration of the material to your upper eyelid.  Good luck!

Andre Berger, MD · Answer

Thank you for your question,
I am sorry to see that you are experiencing unsatisfactory results after your Dysport treatment. In some cases, Dysport can spread a bit father than Botox, which can cause side-effects like a droopy lid. Although these occurrences are rare, they can happen, even with an experienced surgeon injecting the product. I would recommend contacting your surgeon to discuss possible next steps.
  
Best of luck!

Lisa Jenks, MD · Answer

I am sorry you have this problem after your recent Dysport treatment.  When injected by an experienced physician like it sounds you had, this is a rare, but possible complication.  It happens when the Dysport inadvertently enters the muscle that keeps the lid open, causing it to relax, which leads to a droopy lid.  This can happen with either Dysport or Botox, so it certainly does not mean that Dysport is a bad choice for you in the future.  The good news is that it is temporary, but unfortunately, it may take several months to completely wear off.  I would recommend visiting the surgeon who injected you and seeing what his/her suggestions are.  Emergency eye surgery is not an option.Best of luck to you.

Faiyaaz Kalimullah, MD, FAAD · Answer

Thank you for your question and for sharing your concerns.  I'm sorry to hear that you are experiencing complications from your Dysport treatment.  Based on your photo, it sounds like you are be experiencing eyelid ptosis.  This is a rare complication that occurs when Dysport injections between the eyebrows drift and affect the muscles that control the upper eyelid.  It's most often caused by improper injection placement by your injector, and can occur with Botox or Dysport.  Unfortunately, it may take up to 3-4 months for it to fully resolve, but you should start to notice improvement within the next several weeks.  I would recommend following-up with your plastic surgeon to discuss your concerns.  In some cases, your surgeon can prescribe Iopidine eye drops, which can help lift the eyelid by a few millimeters.  I hope you feel better soon!

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