Is it Possible to Raise Droopy Eyelid with Botox? (Photo)

The preseptal eyelid skin below the eyebrow and above the lower part of the upper eyelid is hanging down. The eyebrow descends with time and with it comes the upper eyelid that it supports.  The forehead muscle helps lift the eyebrow, and therefore, the eyelid. By relaxing the depressor muscles of the eyebrow, the forehead can help lift the eyebrow / eyelid complex better.  This is usually done by injecting the glabella with Botox, often with 3 or 5, and even up to 7 insertions sites, with 15 - 25 units or more being used by most doctors. The outer tail of the eyebrow corresponds to the depressor aspect of the periorbital muscle and can be treated with 2 to 3 units.

Ulthera is focused intense ultrasound energy that treats the forehead tissue and helps induce non-surgical forehead lift by tightening the connective tissue layer and producing more collagen, over six months after the procedure. Ultherapy can be repeated in six to twelve months for more of a boost, but unlike Botox is not intended to need continual treatments as the results of Ulthera can be long lasting.

Lastly, some eyebrows have become so saggy because there is a loss of the infrastructure.  By injecting filler into this layer below the eyebrow it can help support the upper eyelid.  I prefer Restylane rather than Juvederm in the eyelid area as there may be more swelling long term from fluid absorbtion with Juvederm.

 Both droopy eyelids and eyebrows can be raised with Botox to some degree, with raising a droopy eyelid being much more difficult and only described well one time in the literature.  Raising a droopy brow is much easier. 
To ensure you are receiving the highest level of care, seek out a modernly trained, new-school dermatologic surgeon, oculoplastic surgeon, facial plastic surgeon or plastic surgeon who is board certified and fellowship trained in one of these "core four" cosmetic specialties. Membership in organizations like the American Academy of Facial Plastic and Reconstructive Surgery help to identify a highly trained surgeon.
Cameron Chesnut#realself500 Physician

Depending on
the positioning of the brow and excess skin, Botox can be used to make the area
appear more rejuvenated. Botox is used to relax
muscles and reduce creases and grooves on the skin. Botox is commonly used for
eyebrows by injecting the muscles that pull the medial ends of the brows down.
This will cause the depressor muscles to lift upwards. Learn more about how
Botox can treat drooping in the eye area below. Read more about Botox brow
lifts below.

Thank you for the pictures.First off, the good news is that this is NOT likely to be permanent and should improve.It appears that you have a drooping eye-BROW that has caused skin gathering over your left upper eye-LID making the eyelid appear like it was drooping. The eyelid, itself, is not droopy however...  This droopy eye-BROW may be corrected with Botox...A drooping eye-BROW may happen in the following scenarios:(1) When the brow-elevating muscle in the forehead, the Frontalis, receives too high a dose of Botox.(2) The Botox is sub-optimally placed too low in the forehead -- it should typically be placed at least 1 cm above the Brow. (3) Over-injection of the glabella area (between the brows). (4) It may also happen if you have a low set eyebrow to begin with, in which case any Botox to the Frontalis increases the likelihood of a brow droop. As mentioned above, a droopy eye-BROW from Botox can sometimes be improved with MORE Botox -- this time, the Botox is typically injected into the outside (top of the crow's feet) part of the eye (aka the lateral aspect of the orbicularis oculi muscle) to generate a bit of a brow lift in that area -- by injecting more Botox and paralyzing the orbicularis muscle that normally acts to depress the brow in that area, you may get a slight compensatory brow lift...Please seek the services of an experienced physician injector. I think the key with Botox lies in truly understanding the anatomy of the injected area, and more importantly the variability in the anatomy between patients -- for brows, the forehead, and anywhere else you plan on receiving a Botox injection. This includes having a firm understanding of the origin, insertion, and action of each muscle that will be injected, the thickness of each muscle targeted, how deep beneath the skin the actual muscle resides, and the patient variability therein. As an aesthetic-trained plastic surgeon, I am intrinsically biased since I operate in the area for browlifts and facelifts, and have a unique perspective to the muscle anatomy since I commonly dissect under the skin, see the actual muscles themselves, and learn "first-hand" the incredible variability between patients -- live, "on the OR table" -- as opposed to via lectures or a cadaver dissection. For me, this helps guide where to inject and where not to. However, with that said, I know many non-aesthetic trained plastic surgeons and other physicians who know the anatomy well despite not operating in that area, and get good results.Good luck.Dr Markarian

It is difficult to tell by the angle of your photo, but it appears as though your brow is the culprit.  It is possible to elevate the brow with the use of neuromodulators such as Botox, and I published a paper approximately 10 years ago which showed just that.  Although results vary among individual patients, by injecting the muscles that depress the brow, such as the orbicularis oculi and the glabellar muscles, up to 5 millimeters of elevation can be achieved.

It is possible to achieve a brow lift using botox or dysport.  The degree of correction varies on individual anatomy and what baseline looks like.  To do a complete brow lift and treat the muscles that are responsible for pulling down the eyebrows and eyes we typically dose the glabella  (11's), the lateral brow and the crow's feet  (the orbicularis oculi muscle.)  Another more cost effective option is to dose only the lateral brow and the glabella.  

Thank you for your question. Botox can be injected between the brow and at the corners of the brow to help relax the muscles that pull down the eyebrows. This can provide a 1-3mm raise of the eyebrows, which would help with the eyelid fullness you have describe. If you are looking for a greater correction then you will benefit more from a surgical option. I recommend having a consultation with an expert to discuss your concerns and to determine the best treatment plan for you. Best of Luck!

Hello, thank you for your question. It is possible to achieve the desired lift in your upper lids with approximately 20 units of Botox.

Botox can indeed help with your drooping eyelid. I would inject the neuromodulator into the depressor muscles, which pull the eyebrow downward. This relaxes them so they do not cause more drooping. Also, the lack of downard pressure allows the forehead muscles to lift the brow, which in turn will pull up the eyelid skin that's now sagging. The exact placement of the injections and the number of units you need will be determined when you consult with a board-certified dermatologist.

Thank you for your question bronzie. I am sorry to hear about your situation and I understand your concern. Botox is a purified protein used to address wrinkles associated with facial expression. When injected into the skin Botox will relax the muscles and smoothen out the overlying wrinkles.
It is difficult to make an assessment in the
absence of consistent photographs before and after in the same lighting and
angles for comparison. However, I hope the information provided here is helpful.
The most common areas of treatment are in the upper face. These include the horizontal lines seen on the upper forehead when one raises the brows, the vertical lines seen between the brows when one frowns (frown lines), and the crow's feet seen around the eyes when one smiles. The appearance of frown lines is variable from person to person. Usually they are in a vertical orientation but sometimes they can be oblique and sometimes a horizontal line is seen across the upper portion of the nasal bridge. The most common variation is to have two parallel lines, hence the common term "11's" to describe them. But some people have one, three, or more lines. Some people also will see a bulge in the area when contracting the muscle. This bulge is smoothened out after a Botox treatment.
The pivotal studies used 20 units of Botox in the glabella area between the brow to address the frown lines. These studies demonstrated that the peak results are seen 14 days after the treatment and most people enjoy their results for 3-4 months. At that point, a maintenance treatment is recommended. While some people start to see results as early as the next day, it can take two weeks for full results so patience is important. We have our patients return 2 weeks after their treatment to assess their results via photographs. At that time additional units may be added if necessary.
With any injection, there are risks such as pain, bleeding, bruising, redness, swelling, tenderness, and infection. We take special precautions to minimize these risks such as using a painless technique. We also treat bruises with a laser as early as the next day. Bruises usually resolve within 2 weeks if untreated. After a laser treatment bruises usually resolve in 1-3 days, but may still take 2 weeks for full resolution. I recommend that my patients apply cold compresses such as ice packs and sleep on an extra pillow if not uncomfortable to reduce swelling.
In addition to these risks, with Botox there is also a risk that the product spreads or diffuses to nearby structures. Most importantly are muscles required to perform various functions. The muscles that are treated with Botox around the eyes are close to the muscle that lifts the upper eyelid. If this muscle is affected it can lead to a temporary droopy eyelid (blepharoptosis). The duration depends on the placement of the product and the dose used. Usually it resolves in 2 weeks, but it can last up to 4 months. Blepharoptosis can be treated with apraclonidine 0.5% ophthalmic solution (also known as iopidine) and various other medications. For my patients, I recommend 2-3 drops to the affected eye 2-3 times per day. When the blepharoptosis begins to wear off patients notice less of a droop when waking up in the morning after the last dose of apraclonidine has worn off. The incidence of blepharoptosis is reported to be approximately 1% but in my experience, I find it to be about 0.1%. This is likely due to the fact that when these studies were initially performed injectors may have not been as aware of this adverse effect nor been taking extra precautions to avoid it.
Blepharoptosis occurs when Botox is placed near the eye and it diffuses to the muscle that lifts the upper eyelid (levator palpebrae superioris). This is located inside of the orbital rim above the globe. To avoid this side effect, I place the product at least 1 cm from the orbital rim. When placing product between the brows I pinch the area to be treated and lift it so that the product is placed in the muscle and is less likely to diffuse around the bone into the orbital space. Diffusion into this area may also be caused by other preventable things. For this reason, I recommend that my patients follow the aftercare instructions below. This may be a reason for the low incidence of side effects in my practice. I encourage my patients to contact our office and return for a follow up visit with any questions or concerns. In addition to such treatment Botox can be placed in the corners of the brows. This will relax the muscle that pulls down on the brow, allowing for a slight elevation of the brow. Sometimes this also helps pull up on the lid and can address blepharoptosis.
After a Botox treatment, I recommend that my patients avoid heat exposure, alcohol consumption, and strenuous exercise for 24 hours and not lie down flat for 4 hours. This is because all of these activities may possibly lead to the movement of the product and consequent side effects such as droopy eyelids as described above. Although there have been no definitive studies shown that these actually occur and some physicians do not provide such aftercare instructions, in the absence of data I err on the side of caution and recommend that my patients avoid such activities.
Botox is what we call a neuromodulator. This means that it controls nerves to prevent the muscles from contracting. Botox is the most popular neuromodulator available, has been the most studied, and is cleared for the most number of indications. Other neuromodulators available in the United States include Dysport, Xeomin, and Mybloc. Overseas many others are also available. Each product has slight differences, but all of them work. The majority of our patients find that they like the results of Botox the best. Additionally, Allergan, the maker of Botox, offers the Brilliant Distinctions Program. This is a rewards program where patients receive points from their Botox treatments which can be used toward discounts at subsequent treatments. Points are also received when patients purchase other treatments in the Allergan portfolio including Juvederm Ultra, Juvederm Ultra Plus, Voluma, Volbella, Vollure, and Kybella or products such as Latisse or Skin Medica products.
I find that combining Botox with other treatments or skin care regimens enhances the results and allows patients to enjoy their results for longer. One specific topical product our patients have found to be outstanding in conjunction with a Botox (and filler) treatment is our Hydrating Serum, which contains hyaluronic acid. Hyaluronic acid draws water into the skin and helps to fill in fine lines and wrinkles.
Please consult with a doctor for specific recommendations. Good luck!