Botox Eyelid Droop with Experienced Doctor?

Question

Hello I got my 4th round of botox with same experienced doctor I have used for years. I got eyelid drop. I went back after a week and the doctor said it happens sometimes and there is no way to predict or prevent it. He said some people have a little hole (while pointing at eyebrow area of skull) and that little hole allows botox to go to eyelid. He said twice that it was not a bad injection. He gave me a few days worth of Upneeq. He said I can get botox in future no problem. Is he lying?

Jason Emer, MD · Answer

For unique cases where a variety of modalities could be used to treat the condition, I would suggest an in person or virtual consultation to develop a custom and effective treatment plan.  It is difficult to precisely define the best option without collecting the same information. I suggest reaching out to an expert for a consultation with surgical and non-surgical methods to get a comprehensive option. Best, Dr. Emer.

James R. Gordon, MD, FACS, FAAO · Answer

Thank you for sharing your experience. It is true that on occasion Botox can spread to a location where it wasn’t injected. This can cause a droopy eyelid. This usually resolves quickly, but can last for awhile. Upneeq often helps. You still can receive Botox injections in the future. I hope this helps. 
Good luck.

Giuseppe Fiore, MD · Answer

Hello,
thanks for your question. 
While Botulinum toxin (e.g. Botox) is a safe and effective treatment for reducing wrinkles and fine lines, there is a risk of eyelid droop, also known as ptosis. 
This can occur when the Botox spreads to the muscles that control the eyelids, causing them to weaken and droop.
Although there is a risk of eyelid droop even in the hands of a highly experienced doctor, the likelihood is significantly lower compared to newly trained practitioners, particularly those who are not doctors.
An experienced doctor will carefully evaluate the patient's facial structure and tailor the injections to the individual's needs, minimizing the risk of complications such as eyelid droop but also manage and eventually prevent/ correct the possible complications. 
If eyelid droop does occur after Botulinum toxin (e.g. Botox) injections, it is usually temporary and resolves within a few weeks as the effects of the treatment wear off. However, it is important to consult with the doctor who performed the injections to ensure proper management and monitoring of the condition. In some cases, additional treatments or medications may be necessary to correct the drooping eyelids.
Hope this helps,
Dr Fiore

Camille Cash, MD · Answer

Drooping of the eyelid can happen with Botox, however you can decrease your chances of the occurrence with an experienced provider.  If the muscle that holds the lid up is injected, droop can be the result.  Fortunately it is temporary and will correct over time.  You can absolutely get Botox again.

Christopher C. Lo, MD · Answer

Thank you for your question and sorry you had this adverse outcome. Eyelid ptosis is a rare, but known, adverse event with even experienced injectors. It is important to choose the right product, correct amount, and location for injection-- though it can happen. The good news is that this will fade in a few weeks (not months) and often upneeq or other eye drops may help mitigate the effect while it wears off. Be well and take care.

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