Sagging Lower Eyelids After Botox

Yes. You are using the circular eyelid muscle to help keep the lower eyelid in position and the cheek muscles help support it as well so if there is a combination of weakening in both of these muscles, then you may notice some sagging of the lower eyelid skin. It is not permanent and will return to baseline after the botox wears off. The lateral cheek area is an area that is to be respected in terms of botox injections.

Botox injected into the lower lid area can cause diminished lower lid tone and lead to the appearance of "sagging lower lids". Botox is wonderful for crow's feet but care must be taken when injected into the lower lid. Patient selection is critical when performing these injections.

The good news is the effects of botox are reversible and this will resolve on its own. inform your doctor of your result and avoid future injections in this area.

good luck

Botox injected too close to the edge of the eyelid can cause the circular muscle around the eye to relax causing this portion of the eyelid to also relax and it may appear as if the eyelid is droopy.  This is a temporary effect and will improve as the Botox wears off.  This same injections are performed in individuals who have small eyes to enlarge them.  In any case, let your surgeon know what happened and to avoid this area in the future.

Botox does not necessarily have the same distribution each time it is injected. This may account for the differences seen from one injection to the next, Botox will weaken the sphincter action of the orbicularis oculi which may produce some weakness in the lower eyelid when injected into the crow's feet area. T

Hi Toronto8610 in Toronto, ON,

As other specialists have already stated, neuromodulators such as Botox Cosmetic may contribute to sagging of the lower eyelid. Crow's feet wrinkles or treatment in the sides of the eye typically do not result in eyelid sagging, but rather Botox injections lower on the eyelid or cheek may. Any sagging from Botox should eventually resolve within a few weeks or months. You may consider a lower dose or avoid treatment in the area all together next time.

Lastly, if your eyelids are generally saggy with bags then lower eyelid surgery with blepharoplasty or possible chemical peel may be appropriate to help tighten the area. Only after a comprehensive evaluation can a dermatologist or eyelid plastic surgeon help determine appropriate options for you. Best of luck.

Dr. Chaboki

Aggressive injection of neuromuscular blockers in the cheek, usually for undesirable "smile lines", can cause sagging of the lower lids, even the inability to smile or an asymmetrical smile.  These changes are usually temporary and should resove in a few weeks to months.  In the meantime, I suggest you consider warm compresses to increase the bloodflow, facial smile exercises, and even direct muscular stimulation by tapping over the cheek and cheekbone to keep your muscles toned.  You may even consider looking into the facial Yoga programs available.   But don't overdo it, you may end up with more of those dreaded "smile lines" when its all over.

Sagging lid after botox will go away given a few weeks. There is nothing to do for now. Next time have your surgeon use a weaker dose.

Botox, when aggressively injected to the side of the eye, can deactivate the cheek lifting muscles and cause the cheeks to slip downward, making the lower eyelids bulge more.

That is the mechanism for your problem.

Many patients who have been getting Botox injections start to notice this problem becoming more and more pronounced as the native cheek drifts further down and deflates.  For those patients, we usually perform a cheeklift with fat-fascial grafts.

Generally, under eye fillers is a much safer because it tend to support the lower eyelid position.  The lower eyelid is delicately balanced against the eye by muscle tension.  Mess with that and the lid slumps.  Good news is that the effect wears off.  Avoid this treatment in the future.

Thank you for your question. Botox will only make this worse. However, Botox may be able to even this out by making your left as weak as your right side, although I am sure this not what you want. You may be able to make this better with fillers, but I think you are better off with surgery to tighten up your eyelid. I recommend having a consultation with an expert to discuss your concerns and to determine the best treatment plan for you. Best of Luck!