Can a better result be obtained with correctly placed Botox, or am I one of those people with extreme sensitivity to the serum?

I had Botox injections into the globula and brow by a leading Atlanta Dematologist eighteen months ago and landed up with severely droopy eye lids, I walked around looking out of slitted eyes for four weeks.

Doctor Answers 7

Droopy eyes after botox

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Droopy eyes can develop from Botox often when placed too low. It does not mean that this would happen every time you have Botox.

New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Brow and Eyelid Drooping

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Botox injections into the wrong muscles, incorrect dose, and wrong patient selection can cause drooping of both the brows and the upper eye lids known as ptosis. Some people have "hooding" of the upper eye lids and keep thier forehead lifted to compensate for the heaviness. Botox injections stops the ability to lift the forehead, making the hooding more noticeable. But, it is most likely that the injections were not placed correctly. I hope you had a follow up appointment two weeks post treatment so your doctor could evaluate your results. Unfortunately, there is not always anything that can be done to correct the problem other than time, as you learned.

Richard Parfitt, MD
Madison Facial Plastic Surgeon
4.4 out of 5 stars 36 reviews

Droopy leads after BOTOX

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Assuming that the BOTOX was placed in the right location by your dermatologist, the dilution factor may play a role. If the BOTOX has a high dilution factor-it has a lot of water in it- it will spread farther that the area injected, and may cause undesirable results, like the one you experienced.

Michel Siegel, MD
Houston Facial Plastic Surgeon
4.6 out of 5 stars 113 reviews

Could the eyelid droop after my Botox been prevented with better placement of the Botox?

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Eyelid droop is a rare, but known, side-effect of Botox.  Yes, it can be prevented with better technique and placement, however with that said -- it happens to many prominent physicians... 

My overall recommendations would be to 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, 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 and see the actual muscles themselves. For me, this helps guide where to inject and where not to. However, with that said, I know many Dermatologists who know the anatomy well despite not operating in that area, and get great results.

Good luck.

Botox Results Are Referred To As "Operator Dependent:" Meaning That Who Injects It Largely Determines The Results

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In medical lingo, we say that the results of Botox injections (as well as those from the use of the other neuromodulators currently available: Dysport and Xeomin) are "operator dependent." This is just a fancy way of saying that the person injecting it is very much responsible for the results obtained.

Now, most of the reasons for an unwanted result have been mentioned, including injecting the wrong muscles, injecting too low on the brow (too close to the eyebrows, rather than staying at least an inch above them), injecting too much, not using the proper concentration, overdiluting the material so that it spreads (diffuses) too far over to areas where it should not have gone. I have been injecting Botox for aesthetic reasons for over twenty-two years, and in that time I have yet to meet a patient who is "extremely sensitive to the serum." It is very unlikely that you are not an appropriate candidate. In the hands of an experienced physician injector, future results should be gratifying.

Nelson Lee Novick, MD
New York Dermatologic Surgeon
4.9 out of 5 stars 33 reviews

Can a better result be obtained with correctly placed Botox, or am I one of those people with extreme sensitivity to the serum?

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Drooping of the eyelids is a potential side effect of Botox, and can occur as a result of poor technique, which may include injecting too much Botox or injecting in the wrong area. Drooping of the eyelids may also sometimes occur even when the injections are performed properly. In general, it is recommended that you seek the advice of a board certified physician when you are looking to have treatment with Botox. A dermatologist, plastic surgeon, or facial plastic surgeon are all great choices. I hope this helps, and I wish you the best of luck.

Paul S. Nassif, MD
Beverly Hills Facial Plastic Surgeon
4.7 out of 5 stars 49 reviews

Can a better result be obtained with correctly placed Botox, or am I one of those people with extreme sensitivity to the serum?

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Its very likely that your Botox wasn't placed correctly, your best option is to wait 3-4 months untill your body has dissolved it compleyely. Seek a reputable medical provider to ensure a result you wish to achieve

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.