Brow lift Botox gave me droopy eyes?!

Question

so why dont doctors explain this beforehand? I got a bit of botox injected to lift my eyebrows. This was two days ago. Since then, my eyes look smaller and my eyelids dropped. Is this permanent? Its like i got the opposite of what I went there for!

Jason Emer, MD · Answer

This could be due to Botox placement. Keep in mind, it will take 1-2 weeks for final results with Botox. If you're unhappy with your final results, venus legacy and thermage treatment can soften results. See an expert. Best, Dr. Emer

Harold J. Kaplan, MD · Answer

Hi GG.  So sorry to hear about your experience.  Not sure why this has happened but it sounds like poor technique.  Yes, even good injectors have the product migrate too low once in a while, but it does sound like the opposite of what you wanted.  With proper injection technique you may be able to get some improvement before the product starts to wear off.  With ptosis (saggy brow or eyelids), you should see improvement after about 3-4 weeks.  To see an example of what a Botox browlift should accomplish, take a look at the ink below.

Ramandeep Sidhu, MD · Answer

Sorry to hear you didn't get the desired effect. Typically combination of forehead and glabellar area botox will give you the eye brow lift but sometimes the trickle effect can relax the muscle that elevates the eyelid and usually this is temporary and recovers much faster than the actual botox for the eyebrow lift.

Michael K. Lee, MD, FACS · Answer

I'm sorry that you got the opposite effect than intended. Botox can give an eyebrow lift with pleasing results if injected properly. However, a known adverse effect of Botox is ptosis or the droopiness. It can either be from:
1) Brow ptosis - caused by injections low on the forehead muscles leading to lowering of the eyebrows
2) Eyelid ptosis - caused by diffusion of Botox to the muscle that elevates the eyelid leading to lowering of the upper eyelid
Botox is not permanent so the results will wear off after a few months. If you have eyelid ptosis, there are prescription eyedrops which may help with some of the droopiness. Thanks for your question and hope this helps!

Philip Solomon, MD, FRCS · Answer

Botox essentially has a push pull effect. The muscles in the forehead lift the brows where as the muscles around the eye pull the brow downward.  If you are looking to raise the eyebrow, the injection sight is placed lateral to the eye and slightly below the brow. This will relax the muscle around the eye causing the forehead muscle to pull the brow upwards. Perhaps your injector treated the wrong muscle. Thats unfortunate. Botox is temporary and your brow should restore it's natural position in a couple months. Seeking an experienced provider is essential.

George Ibrahim, MD · Answer

We caution every single patient that droopy eyes after neuromodulators may occur, every time!  The best injectors in the world will see this every once in a while.  The reality is that the most perfectly placed product may migrate, often times with the help of the patient unknowingly touching, massaging, and moving the product to an area outside of where it was intended.  The great news is, it will resolve on its own over time.

Melvin Elson, MD · Answer

It is not clear where you were injected but injection in the eyebrows will always cause ptosis.  Iopidine eye drops will help and it is not permanent. Be sure you see a board certified dermatologist

Shaun Patel, MD · Answer

Sorry to hear about your experience. It's the responsibility of the doctor to get an adequate informed consent prior to any medical treatment and this should include the side effects of the treatment. Eyebrow ptosis (droopiness) can be seen after Botox/Dysport treatment but this is most commonly due to injection technique or too high of a dose being used. I recommend you followup with your injector to discuss you concerns and results and to see if anything can be done about it. Remember, the eyebrows will return to normal on their own as the Botox/Dysport wears off over the next 3-4 months.

Alain Michon, MD · Answer

Thank you for your question. I am sorry you are having this issue. For a brow lift, the superior and lateral portion of the muscle around the eye is treated. This muscle pulls down on the brow and when relaxed after Botox, the brow will lift up. On the other hand, the frontalis muscle lift the brows up and when injected it can cause a droop. 
Rarely, the eyelids can also be affected. If this is the case, Iopidine drops can be prescribed. This will help elevate the eyelid by 1-3 mm.  I recommend returning to your injector for a proper follow up, examination and treatment plan. 
Botox is not permanent and you should see an improvement within 4 - 6 weeks and complete resolution at 3 to 4 months after your initial injections. All the best, Dr. Michon

Beata Danek, MD · Answer

Botox results are not permanent so your eyes will get back to normal in a few weeks. I suggest to wait at least one week and if it is not improving go back to your doctor for advice. It could be wrong technique but it also could be Botox migration due to your position (you need to be up for 2 hrs after the injection), or your touching and moving it up. It can also be just heavy eyes sensation that will go away in a few days - it is unlikely to have eye drop just 2 days after the injection.

Brow lift Botox gave me droopy eyes?!

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