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Did my doctor inject botox too close to my eyelids? Will I get droopy eyes? (Photo)

I got botox today and i went to a new doctor since i moved, the first time i got botox he injected at the 5 typical injection sites that you can find in a simple google search, 4 units in each spot and the results were perfect, exactly what i wanted. This new doctor injected in slightly lower and different spots and I'm worried I'll have droopy eyes. Here's a picture showing where he injected. 2.5 units at the outside sites, 6 at the beginning of the eyebrows and 8 in the middle.

Doctor Answers 11

August 7th, 2016

Botox for frown lines

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Thank you for your question veralina4848. Botox is a purified protein used to address wrinkles associated with facial expressions such as the vertical lines seen between the brows when one frowns. In our office we keep specific records of exactly how many units and the locations for each Botox injection. In this way if a patient moves to a different city their new injector can have the detailed notes and make similar injections. When I have a new patient who had a Botox treatment elsewhere I always ask how the results were. If they were good I ask how many units were used. In this way I can perform a treatment using similar dosing. If this is not available I make an assessment I use a dose that I feel would work based on previous experience. The pivotal studies demonstrated that most people enjoy their results for 3-4 months after a treatment using 20 units in this area. Every patient has slight anatomical differences and injections are made based on where the muscle is seen. The good news is that droopy eyelids are temporary and treatable. Please follow up with your doctor for specific recommendations. Good luck!

Alex Eshaghian, MD, PhD
June 13th, 2016

Botox injections with a new physician

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I practice in an area where a large portion of the population either come from other locations to relocate or are travelling here for only a brief time.  Botox injections can seem formulaic and that is why many non plastic surgical specialties are comfortable offering Botox injections.  Every individual is slightly different.  When a patient who has had Botox in the past is seeing me for the first time I ask if they were happy with their prior treatment outcomes.  If the answer is yes, then I ask if they have access to their records so that we can duplicate Botox injections they were very pleased with, including location and number of units.  If the chart is unavailable, they were not pleased with their prior results, or the units do not seem correct, I will use my experience to inject neuromodulators in the areas they would like treated with the amount and locations I have been most successful with. I would ere on the side of conservatism in first time patients.
Philip S. Schoenfeld, MD, FACS

Philip S. Schoenfeld, MD, FACS
Chevy Chase Facial Plastic Surgeon
4.8 out of 5 stars 34 reviews

June 9th, 2016

Injection too low with Botox?

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I usually inject higher in the lateral corrugator muscle area. It is unlikely that there will be a problem but unfortunately, there's not much which can be done currently. Wait out the 7 days and see what happens. Discuss with your doctor next time if you have concerns. In a recent meeting, lid ptosis causes were discussed and it seemed like Botox travelling down the supraorbital foramen was probably the reason it happens. So large volumes, downward angle of needle, and deep placement are more likely factors than low placement.

Learn more: https://stevenfweinermd.wordpress.com/2014/10/12/all-botox-providers-are-not-the-same-choose-carefully/

Steven F. Weiner, MD

Steven F. Weiner, MD
Panama City Facial Plastic Surgeon
4.9 out of 5 stars 75 reviews

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June 9th, 2016

Did my doctor inject botox too close to my eyelids? Will I get droopy eyes?

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Thank you for your excellent question.  Each new physician that you have perform Botox will have slightly different injection techniques as well as concentration and total unit amounts.  Since you just had the injections performed today only time will tell what this pattern of injections will have on your appearance.  Hang in there!

Learn more: http://www.nelson-center.com/wrinkle-relaxers.html

Nelson Castillo, MD

Nelson Castillo, MD
Atlanta Plastic Surgeon
5.0 out of 5 stars 80 reviews

June 9th, 2016

Botox injections too close

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The best thing is to wait and see.  The injections on the outermost look a little bit close to the brow region but it is difficult to state based just on the position of the eyebrow.  The most important aspect is to keep the injections roughly 1 cm above the orbital bone/ridge in this region.  In addition, injections should be more superficial as opposed to the central region because the tail of the corrugator muscle is superficial whereas the head in the central portion tends to be deeper.  You only had 2.5 units placed so it should be fine. 


All the best
Dr H Soni

Hardik Soni, MD (not currently practicing)
Summit Emergency Medicine Physician

June 9th, 2016

Botox and Ptosis

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Thank you for your question and for sharing your photograph.  Sorry to hear that you are having some concerns about your Botox treatment.  An experienced injector will be able to evaluate your facial muscle activity during an in-person consultation in order to determine the best approach to both accomplish your treatment goals and avoid any ptosis.  Please keep in mind that you will see your final result after Botox treatment in 2 weeks.  At that point, if you have any concerns about your appearance, please see your injector for an in-person reevaluation in order to best address your concerns and to determine the best course of action.  Best wishes!
Christian N. Ford, M.D.
June 9th, 2016

Don't know

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Drooping eyelids/brow typically come from injections on the forehead.  The puncture site is not necessarily where the botox is delivered because of the angle of the needle.  If you haven't had any drooping at 5-10 days, it is unlikely that you will get it.  There are eye drops that can be given in the unlikely event that you have drooping.  Good luck. 

Elliot Duboys, MD, FACS
Long Island Plastic Surgeon

June 9th, 2016

Botox Injection Techniques

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Some doctors do things a bit differently. See how you like your results and take it from there. Good luck!
Robert M. Tornambe, MD

Robert M. Tornambe, MD
New York Plastic Surgeon
5.0 out of 5 stars 33 reviews

June 9th, 2016

Was Botox injected improperly?

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Thank you for sharing your concerns. If the marked areas were the site of injection, it seems a little low. If he angled the needle or was simply marking the area where he saw the most muscle activity, then the placement might not be at the marks. You will know by seeing the results within a week.
Good luck,

Learn more: http://www.CosmeticEyelids.com

James R. Gordon, MD, FACS, FAAO
June 8th, 2016

Was Botox injected too close to eyelids?

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From the photo that you provided that shows your Botox injection points, I would say that it would be unlikely that you would have droopy eyelids as a result of your treatment.    
Michael I. Echavez, MD

Michael I. Echavez, MD
San Francisco Facial Plastic Surgeon
4.5 out of 5 stars 18 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.