Botox Caused Ptosis. Is It Permanent?

i had botox for crows feet, above brows and between brows 4/15/10. ptosis developed in rt lid 4/24/10. by the end of the summer, august, it looked pretty good. it has not completely resolved. my lid is still lower on that iris and the shape of my eye still looks different.have i had permanent damage? will exercising the lid help? desperate

Doctor Answers 20

Ptosis after Botox Treatment. How to manage it ?

Hello and thank you for the question.

The effects of Botox are not permanent. In general you can expect results lasting anywhere from 6 weeks to 6 months. Regarding the eyelid ptosis, while this is a rare event following Botox treatment, it is well documented. I suggest following up with your clinician and inquire to see if you are a candidate for iopidine drops. This treatment works quite well and will typically raise your affected lid one to 3 millimeters to give you better symmetry until the effects of the chemodenervation agent resolves.


Glenn Vallecillos, M.D., F.A.C.S.

Beverly Hills Plastic Surgeon
4.9 out of 5 stars 31 reviews

Botox ptosis of the eyelid is never permanent.

Botox can cause a temporary ptosis of the eyelids which resolves over 2-4 weeks usually.  Botox affect should be totally gone by 6 months.  Anything after that is not due to the botox.

David Hansen, MD
Beverly Hills Dermatologic Surgeon
4.7 out of 5 stars 43 reviews

There is no permanent damage from Botox

There is no permanent damage from Botox.  You may take a little longer to recover and you may also have a slight asymmetry that you did not notice before that will always be there.  If you can look at some of your old photos and see if you see something

Martin Jugenburg, MD
Toronto Plastic Surgeon
4.9 out of 5 stars 469 reviews

Not permanent

I'm sorry to hear that your results were not as you expected. Fortunately for you, Botox does not achieve permanent results. A treatment tends to achieve results that last about 3-4 months, or a little longer if you've received several treatments before. If you wait, this will gradually go away. Best of luck!

Jerome Edelstein, MD
Toronto Plastic Surgeon
5.0 out of 5 stars 179 reviews

Botox, ptosis, and permanency

The answer is simple: No. But it does take a while for it to come back (the eyelid function), and that can be distressing. I have not had ptosis as a complication, luckily, so although I know about lopidine, I have not used it, and can not attest to the quality of its reversal.

Srdjan Ostric, MD
Chicago Plastic Surgeon

Ptosis is usually a result of poor injection technique

It is not permanent and can be treated by using a drop called Iopidine. It is usually caused by the doctor injecting too low on the lateral injectons over the brow. I have never seen it last 6 months in my own patients.In the study for FDA approval I developed the injections sites to avoid ptosis. Please review These sites. Also if a doctor dilutes the vial with 5cc or more this can cause ptous

Arnold W. Klein, MD (in memoriam)
Beverly Hills Dermatologic Surgeon
4.8 out of 5 stars 5 reviews

Botox Not Permanent

Botox is not permanent.  Don't worry, the effects of your botox treatment should go away around 4 to 6 months.

C. Bob Basu, MD, FACS
Houston Plastic Surgeon
4.7 out of 5 stars 211 reviews

Botox and longevity of effects on upper eyelid ptosis.

The effects of botox should not be permanent and your eye should essentially reuturn to its baseline by 6 months.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 82 reviews

Droopy eyelid after Botox, Dysport, or other neuromuscular blockers

Permanent weakness of facial muscles may be seen with any prolonged neuromuscular block over time.  This is how we intentionally induce muscular atrophy of specific expressive muscles to clear unwanted lines.  Atrophy will begin to show up if any muscle is not stimulated or innervated after 6 months or more.  The persistence of ptosis or droopy eyelids is extremely unusual as the levator muscle of the eye is not an intended target, but can be involved with unintended exposure by injection.  You may want to ask your physician for a prescription for an α2-adrenergic agonist, which causes Müller muscles to contract, quickly elevating the upper eyelid 1-3 mm.  This may or may not be effective along with eyelid exercises in front of a mirror.  Finally, permanent ptosis can be corrected surgically, but this would only be a solution of last resort.

Randy Wong, MD
Honolulu Plastic Surgeon
4.8 out of 5 stars 36 reviews

Droopy Eyelid after Botox Cosmetic or Dysport

Hi Dayton9423 in Dayton, Oh,

Ptosis, a droopy upper eyelid, is uncommon and may occur with anyone after any neuromodulator treatment around the eyes, such as Botox Cosmetic or Dysport. Ptosis is temporary and resolves once the Botox effect is gone, usually within a couple months. This temporary eyelid ptosis is usually treated with eye drops to help stimulate other muscles to lift the eyelid. Massage or facial exercises don't help to improve ptosis. Also, one should not be massaging the face the first 24 hours after these injections. Speak with a specialist to help determine appropriate options for you. Best of luck.

Dr. Chaboki

Houtan Chaboki, MD
Washington DC Facial Plastic Surgeon
4.9 out of 5 stars 85 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.