Do Botox brow lifts lead to droopy eyelid in the long term?

Question

I’ve been get Botox since I was 27 (now 34 ) in the crows feet for prevention. My injector has always put in 3 units in the tail of my eyebrow to give me a lift along with my crow feet injections. Which I’m not sure I even need cause I have natural high brows. Since Botox weaken the muscles will this cause me long term effects, such as droopy eyelids due to weaken muscles?

Luis Villar, MD, FACS · Answer

Everything sags over time, but in your case, Botox/Xeomin will not be the cause.  if you are only injecting the crows feet and not the forehead, there is no reason to believe there will be any effect to the frontalis muscles that lift the forehead.  Theoretically, if you keep muscles paralyzed, they will atrophy.  But to measure and document this is almost impossible because neurotoxin's onset and duration is different in every patient and the forehead naturally drops with age, but differently in every patient.  3D imaging of patients with neurotoxin injected into one side of the forehead only and followed for thirty or forty years might give us an answer, but you wont find any volunteers.  The important thing is to enjoy life, and look your best now, as if there is no tomorrow.

Jason Emer, MD · Answer

As we age, our eyelids naturally sag and droop. A combination approach would be best to see visible improvement. In terms of non-surgical treatment options, I would recommend a Chemical Brow Lift (using Botox, Dysport, Xeomin, or Jeuveau) and filler injections to rejuvenate the temples, eyebrow, eyelid, eye troughs, upper eye hollows, and forehead. I typically combine this with Ultherapy and thread lifting to lift the brow; RF and skin tightening laser treatments to stimulate collagen production and rejuvenate the skin; and laser or superficial RF devices for improvements in texture, color, and any crepey skin around the eyes as needed. In some cases, surgery is the best solution to achieve the desired results. See an expert for a formal consultation. Best, Dr. Emer.​

Nirmal Nathan, MD · Answer

Dear Real34,Botox should not cause long term problems in your eyelid position, although the frontalis muscle does weaken over time. Could injecting the forehead muscle cause problems with brow position over time? I don't think anyone could tell you with 100% certainty that it does not happen. The most common brow issue I see in my injectable patients is just droopiness from gravity and normal aging, not from Botox. Remember, brow position is independent and distinct from true eyelid droopiness. Best regards,Nirmal R. Nathan, M.D.
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgeons

Camille Cash, MD · Answer

Botox injected for the crow's feet will not cause your eyes to sag in the long term. While we can't stop the aging process, Botox does allow us to help patients achieve a more youthful appearance without surgery.

Onir Spiegel, DDS, PhD · Answer

Botox for eye brow lift is a great choice.  We'll be posting a new video on this very topic next week.  So please check back.  Long term botulinum injections will not lead to a droopy eye lead. What does lead to that is injecting too lateral in the forehead. All the best from Boston,  Dr. Onir

Center for Aesthetics and Plastic Surgery - Grand Rapids · Answer

Hello there! Botox should not cause you any long term droopiness in this area. Any drooping you see in the upper eyelid will probably be caused by natural aging and skin laxity. There are surgical and non-surgical treatments for this laxity.  Good luck! Sarah RN BSN

Leonard Grossman, MD · Answer

As a person gets older they see what appears to be excess eyelid skin. Not that we grow the skin as we get older but we lose volume in the face in terms of muscle and fat therefore our face deflates and makes it look like there is more skin. you have nothing to worry about and you may continue with your Botox treatments. When the time comes and you'd like to look younger, you can always have fat grafting performed and that will make you look considerably more youthful with practically no down time and few if any risks. Good luck from New York City

Maria Milone, MBBS · Answer

Botox will not cause any unwanted effect such as droopy eyelids in the long term.The muscle relaxation wears off after 3 to 6 months with full recovery of function.Relax and be assured that it will have only positive effects on ageing .

Do Botox brow lifts lead to droopy eyelid in the long term?

Answers (8)

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