Can drooping eyelids be corrected with more Botox?

I had Botox only along the outer brow, none in my forehead, and it seems to have migrated to my upper lids. I really got no lift at all from the injections, and now my lids are droopy, especially in the morning, and my brows actually seem a tiny bit lower. It's been ten days. Since I didn't have Botox anywhere else, could this be corrected by more Botox along the outer brow/tail, but a little higher and further away from the levitor muscles?

Doctor Answers 7

Don't Add More BOTOX

The question is — and this can only be determined by a physical exam — did your brows droop or did you get a droopy eyelid, or maybe even both? It is not uncommon for a person's brow to droop after a significant treatment with BOTOX® Cosmetic. If your arm becomes paralyzed, it will hang; it does not float in the air. The same is true with your brow. BOTOX can weaken the forehead muscle, and your brow may droop a few millimeters. Many people think that this is a droopy eyelid — the upper eyelid has become less defined because of the sagging brow. Although we would prefer this not to happen, it usually regresses in a week or 2. A droopy eyelid is a totally different matter. This happens if the BOTOX migrates downward and affects the ability of the levator muscle to elevate the eyelid. There are drops to help minimize this effect, but it will improve in a few weeks, as well. Adding more BOTOX will probably not improve the situation in either case. Good luck.

New York Plastic Surgeon
4.6 out of 5 stars 13 reviews

Botox and Eyelid Ptosis

The neurotoxin migrated to the upper lid levator muscle and affected the strength of the muscle. Daily Iopidine eye drops (a prescription medication) may help. Otherwise, every week it will get a little better and better as the Botox wears off. The effects may last 3-4 months.

Contact a Board Certified Plastic Surgeon

Best wishes

George C. Peck, Jr, MD
West Orange Plastic Surgeon
4.8 out of 5 stars 22 reviews

Can drooping eyelids be corrected with more Botox?

Because Botox last for a few months (usually 3-4) it's probably not best to add any more, even as a correction. I would recommend waiting until this round has worn off before attempting anything else.

Daniel Shapiro, MD
Scottsdale Plastic Surgeon
4.8 out of 5 stars 107 reviews

Droop from Botox?

The first thing to etermine is whether your lid is drooping or your brow is lowered, or both. YOu won't correct a droopy lip with more product but might benefit from eye drops. Also, lid droop does not usually last as long as the Botox lasts. If you are getting brow lowering you would benefit from injecting the glabellar area. Go see an experienced injector and they will evaluate you.

Jo Herzog, MD
Birmingham Dermatologist
5.0 out of 5 stars 19 reviews

Can drooping eyelids be corrected with more Botox?

Botox last 3-4 months on most patients but I don’t recommend you add more units until the effects of your treatment has worn off 

Kenneth B. Hughes, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 496 reviews

Lid Droop

Adding more Botox in this situation might be adding fuel to the fire, especially if not placed properly. At this point, your lid droop does not seem so bad, so you might just wait it out. Your story is typical as the lid droop ( lid ptosis) is worse in the morning. However, if this worsens, you might see your physician for a prescription of Iopidine ( cleverly named, as IOP stands for intra-ocular pressure), generic name: apraclonidine. This drug activates Muller muscles to contract, raising the lid a bit. 

  It is true that brow drop can be corrected to an extent by judicious placement of Botox, but this does not hold for lid drop. So, you might consult your physician regarding this.

Arnold R. Oppenheim, MD
Virginia Beach Dermatologist
4.7 out of 5 stars 14 reviews

More Botox?

Botox does not migrate.  Without knowing the volume that was injected, it is difficult to comment but it seems as though you should be injected in the mid-brow and forehead as well.  Demonstrate your areas of concern to the plastic surgeon or dermatologist and he will be able to target the correct areas.

Robert L. Kraft, MD, FACS
New York Plastic Surgeon
5.0 out of 5 stars 42 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.