How Long Does Eyelid Droop Last After Botox?

Question

How long will my eyelid drooping last after a botox injection in the frown? It drooped after seven days of the injection!

Otto Joseph Placik, MD · Answer

The eyelid droop can last anywhere form 4 days (for swelling) up to 6 months for true levator denervation.

Mark K. Markarian, MD, MSPH, FACS · Answer

Short answer -- less than a month... typically.  Please read on for the explanation...A droopy upper eye-LID may occur if the Botox is injected too close to your eyelid-elevating muscle, the levator palpebra superioris. In such a scenario, the Botox will diffuse inadvertently onto the levator muscle and cause an eyelid droop. Typically, a lower dose diffuses onto the levator muscle and so the other good news is that the eyelid droop will typically NOT last as long as the full Botox duration of 3-4 months, and may in fact resolve in less than a month -- the likely case in your situation. Note however, if the eyelid droop occurs shortly after injection (i.e. within 3-4 days), then your eyelid levator muscle likely received a significant dose of Botox and your eyelid droop may not resolve for 1-2 months...On a side note, you may have an increased risk of eye-LID drooping if you have a weakened upper eyelid muscle for neurological reasons, or a deeply set eye-BROW that would be more prone to drooping and result in skin gathering over the eyelid making the eyelid appear like it was drooping. A droopy eye-LID due to Botox can be treated with Apraclonidine eye-drops which can provide a small (2mm) improvement -- Apraclonidine 0.5, 1-2 drops, 3 times per day. Make sure you put in one drop at a time, tilt your head back, and close your eyes to make sure none of the eye-drop leaks out. Be sure your prescribing physician discusses all the potential side-effects of the drops, such as "adrenaline-like" symptoms like anxiety or heart pounding; you may also experience eye irritation, eye dryness, and eye pain, amongst other symptoms. If these symptoms occur, you will likely need to take some lubricating eye drops, lower the dose, switch the eye-drops, or stop the drops altogether...My overall recommendations with Botox are to seek the services of an experienced physician injector. I think the key with Botox lies in truly understanding the anatomy of the injected area, and more importantly the variability in the anatomy between patients -- for brows, the forehead, and anywhere else you plan on receiving a Botox injection. This includes having a firm understanding of the origin, insertion, and action of each muscle that will be injected, the thickness of each muscle targeted, how deep beneath the skin the actual muscle resides, and the patient variability therein. As an aesthetic-trained plastic surgeon, I am intrinsically biased since I operate in the area for browlifts and facelifts, and have a unique perspective to the muscle anatomy since I commonly dissect under the skin, see the actual muscles themselves, and learn "first-hand" the incredible variability between patients -- live, "on the OR table" -- as opposed to via lectures or a cadaver dissection. For me, this helps guide where to inject and where not to. However, with that said, I know many non-aesthetic trained plastic surgeons and other physicians who know the anatomy well despite not operating in that area, and get good results.Good luck.Dr Markarian

David Hansen, MD · Answer

Eyelid drooping usually resolves in 3 weeks but may last 3 months.  Iopidine drops help.  Too much botox or injecting it too low into the eyebrows are usually the cause but it always resolves with time.

Kenneth D. Steinsapir, MD · Answer

Brow droop is the result of the forehead being over treated.  Typically the bothersome effect is the results of a fairly large dose of BOTOX distributed over the entire forehead.  As the BOTOX effects wear off, the brow droop gradually improves usually over 3 to 4 months.

	Eyelid droop is an entirely different problem.  This occurs when treatment from above the eyebrow gets into the upper eyelid lifting mechanism.  There are for a variety of medical reasons why doctors need to create a temporary eyelid ptosis.  This is done by directly injecting the muscle responsible for lifting the eyelid with BOTOX.  It takes at least 5 Units of BOTOX to knock out this muscle.  Average duration of the induced ptosis is about 10 weeks.  This is by way of telling you that it takes a real amount of BOTOX to actually drop the eyelid not a trace amount.

	How long does upper eyelid ptosis caused by BOTOX last?  From as little as one or two weeks to as long as 6 months and rarely more.  I should stress rarely because these are rare situations.  Iopidine is a drop that can stimulate an accessory muscle that helps lift the eyelid.  For some this is helpful until the effect wears off. However how you do with the drop may predict how long the droopiness will last.  I studied 7 patients with long term ptosis after BOTOX treatment.  It turns out that an initial response to Iopidine is associated with a noticeable improvement in 4 to 6 weeks.  If you don't have an improvement when you first use the drops, this suggest an more severe eyelid paralysis and these can take 3 to 6 months to resolve and rarely longer.

Ron Shelton, MD · Answer

eyelid drooping may occur after the forehead muscle drops too much from too much Botox and the forehead muscle drops along with the eyelid that it holds up.  Another possible cause of eyelid droop is having had injection sites pefomred  too low on the forehead. Eyelid drooping may last for more than three months.  If it is a true solitary eyelid droop, a ptosis, then Iopidine drops can stimulate the eyelid to lift up slightly improving the asymmetry. If only the forehead was treated, then your glabella (area between the eyebrows) should be treated along with the outer eyebrows as these areas will slightly lift up the forehead and with that, the eyelids.

How Long Does Eyelid Droop Last After Botox?

Answers (8)

Answer: Brow droop or eyelid droop are different

Answer: Brow droop or eyelid droop are different

Answer: Eyelid drooping after treating the frown with Botox

Answer: Eyelid drooping after treating the frown with Botox

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Everything you need to know about Botox

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How Long Does Eyelid Droop Last After Botox?

Answers (8)

Answer: Brow droop or eyelid droop are different

Answer: Brow droop or eyelid droop are different

Answer: Eyelid drooping after treating the frown with Botox

Answer: Eyelid drooping after treating the frown with Botox

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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.