Can Botox cause ptosis or permanent muscle paralysis?

Question

I started getting Botox several years ago and I admit, there were times I have gone overboard. I haven't had any injections in about 7 months and I like how things are looking..except I've noticed that my eyelids are abnormally droopy. I don't think it is normal signs of aging. I am 27. I had my injections done by a nurse every time. Could this be caused by the Botox or possibly be a mistake on her part? And if so, is it permanent? My eyelids were never droopy before I started getting Botox.

Juan Carlos Fuentes, MD · Answer

Botox relaxes the muscles, but the effect is not permanent, and even that you have not had it for the last 7 months, what you may notice is that the frontalis muscle is not as strong as use to be, because the muscle has not regain its full strength. The frontalis muscle is the only muscle that lifts the brows, so to avoid droopiness on the brows, avoid getting Botox in the frontalis muscle, and you can just get it done in the orbicularis oculi and corrugator muscles, that are muscles that pull down the brows, so your brows go up again.

Jason Emer, MD · Answer

Botox results are not permanent, and after many years of doing injections I suggest you speak to someone to evaluate your eyelids.  Best, Dr. Emer.

Martie Gidon, MD, FRCPC, FAAD · Answer

If you have been having Botox injections for years, at 7 months you may still have a Botox effect in the glabellar area but not in other areas.  An experienced cosmetic dermatologist or plastic surgeon can assess your muscle movement to determine if it is time for a Botox brow lift or if you have naturally developed droopy eyelids.  The effects of Botox can be long-lasting in some patients, but not permanent.

Farzad Yaghouti, MD · Answer

Hi,  I recommend that you do not get another Botox injection and go see an ophthalmologist to evaluate your eyelid function. As frequent Botox injections can lead to a frontalis muscle atrophy, it is possible that may lead to a permanent lowering of the eyebrow and the eyelids. Best, Dr. Yaghouti

Clyde Mathison, MD · Answer

Botox wears off with time.  I don't think your complaint of "abnormally droopy eyelids" is related to serial Botox injections.  I recommend being evaluated by an ophthalmologist who can exam you for any eyelid pathology that might be present.  Good luck!

Can Botox cause ptosis or permanent muscle paralysis?

Answers (9)

Answer: Botox effect on lids

Answer: Botox effect on lids

Answer: Botox and droopy eyelids

Answer: Botox and droopy eyelids

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Can Botox cause ptosis or permanent muscle paralysis?

Answers (9)

Answer: Botox effect on lids

Answer: Botox effect on lids

Answer: Botox and droopy eyelids

Answer: Botox and droopy eyelids

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Recommended reading

Everything you need to know about Botox

Our mission is to create a world where every investment in modern beauty is Worth It.