Can Heat Help Metabolize Dysport Faster?

Question

I am extremely unhappy with Dysport injections I had done for crows feet. I now have big bags under my eyes that are very pronounced especially when I smile. My provider said that heat can help speed up the metabolizing of the Dysport and to apply warm compresses to the areas once a day for 15 - 20 minutes. I have been doing this much more than that for the last week hoping to see some change. I can't find any information to support this claim so I am hoping a Dr. out there can respond.

Robert A. Weiss, MD · Answer

It is unusual to develop baggy eyelids after a botulinum toxin injection for crow's feet, whether it is Dysport or Botox.   However in some people the muscle around the eye (orbicularis) helps push fluid away especially after it accumulates while we are sleeping.  When we are awake and upright, gravity helps any fluid causing bags to drain.  Heat will not necessarily reduce the fluid.  The eye bags will diminish over 2 -3 months

	My recommendations are:

	
		If you decide to treat Crow's feet in the future, the Dysport should be placed further away from eye
	
		Avoid injection into the lower eyelid
	
		Sleep on two or more pillows to keep your head upright.

Jessica J. Krant, MD, MPH · Answer

Phoenix,
	I am sorry you are unhappy with your recent Dysport treatment for crow's feet. I can understand how the bags are increased under your eyes. That's a commonly misunderstood potential side effect when the periorbital muscle band is made too weak. Unfortunately, Dysport and Botox permanently attach to their targets and don't "metabolize". The nerves have to actually regnerate new signalling molecules to start working again, and there is no way to speed that up. I wish you luck, but at least you know that in a few months you will be back to normal.

Marc Cohen, MD (retired) · Answer

Dysport does not usually cause under eye bags.  However, if you are a person whose eyes swell easily, Dysport or Botox could make that problem worse.  The reason is that the muscles under yours eyes pump away fluid in the tissue when you blink.  If the Dysport was given to the lower part of your crowsfeet and very close to the area under your eye, it may make your swelling worse by temporarily weakening the muscles that pump away the fluid.

	If you are swelling a lot you may have ocular allergies.  Do your eyes tend to itch?  If so you may benefit from an over the counter allergy eye drop like Patanol or Zaditor.  If you control allergies, the swelling will improve.  It is also worthwhile to avoid very salty food, which also makes the eyelids swell.

	The good news is that Dysport will wear off in a few months.  Unfortunately, I don't think that warm compresses will speed that process.

Can Heat Help Metabolize Dysport Faster?

Answers (3)