Woke up with my left eye looking smaller than my right eye. Had Botox on 12/18. Is this a result from Botox? (photos)

Question

A week ago I woke up with my left eye looking smaller than my right eye at first I though I was just tired but it's been a week my eye still noticeable smaller other. FYI: My left eye has always been smaller than my right one, pic @ left was taken in 10/18, puc @ right 2/19.I'm 34yrs had Botox in upper face including under brow in 12/18. Is this a result from Botox? I've been to the optamologist everything was fine? Is this permanent? can this be corrected? Please help

Robert H. Cohen, MD · Answer

pinkdustmagic34 Thank you for your question. From your injection placement and timing description, your history of, "My left eye has always been smaller than my right one.", the presented pictures and your subsequent normal visit to the ophthalmologist, I suggest that this is not due to the Botox injections. I recommend waiting for a full three months for the majority of the Botox effects to cease. At that time, you may want to visit your doctor and have them inject a few strategically placed units of Botox to open up the lower eyelid to achieve parity with your right eye. I hope this helps. Have a wonderful day! Best, Robert H. Cohen, MD

Jason Emer, MD · Answer

Botox results take up to 1-2 weeks and last up to 3-4 months. It can be softened with venus legacy and thermage treatments. I recommend getting a formal evaluation with a cosmetic dermatologist. Best, Dr. Emer

Johnson C. Lee, MD · Answer

Thank you for your photos. Even without botox, you have some ptosis to your eyelids (drooping) with your left eye being more ptotic than your right. This can be corrected with an eyelid lift procedure to tighten the muscle which positions the eyelid. In patients who have borderline ptosis, botox can relax the forehead enough that the ptosis becomes more apparent. This is a possibility with you, however this will occur early on when the botox kicks in. It is unlikely that the eyelids will drop about 4 weeks after injection. Regardless, botox always wears off and any effects of the botox are not permanent. Hope this helps!

Johnson C. Lee, MD
Board-Certified Plastic Surgeon

Johnson C. Lee, MD 
Board-Certified Plastic Surgeon

Lamia Wassef, MD · Answer

thanks for your question 
What I can see in both pictures that your lt eye is smaller than the Right one
If it is side effect of Botox it would happened in the first 2wks
And even if it is side effect of the Botox it will wear off with time and back to normal in 4-6 m
I hope everything will be ok for you
Regards, Dr Wassef, ottawa

Paul Fondacaro, MD · Answer

It is highly unlikely that what you described could be related to Botox. You were treated two months prior and so if anything the results from Botox should be diminishing. I hope this helps

Ghazwan Sharabi, MD · Answer

If you compare both pictures (before and after I assume) then you will notice that have had a lower left eye blepharospasm. This is unrelated to your Botox treatment. In fact a microdroplet technique of your left lower eyelid with Botox will open your left lower eyelid and gives you an even eye opening.
I am glad you had the before picture to compare. It is sad that your ophthalmologist did not pick that up. Hope this is helpful information for you.

Camille Cash, MD · Answer

It would be unlikely for new symptoms to occur approximately 2 months after injection of Botox.  Botox results are considered in full effect 2 weeks after injection and wear off gradually over a 3-4 month time period.  I hope this is helpful.

Ahad Mahootchi, MD · Answer

It's hard to say based on the photo as you had some ptosis before. It's possible if the injection was placed in certain area.The good news is that if it is the botox making things worse, it will wear off like all botox does. It would be a good idea to have the person who injected the botox take a look so they can modify the injection placement next time.

Woke up with my left eye looking smaller than my right eye. Had Botox on 12/18. Is this a result from Botox? (photos)

Answers (8)

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