Drooping eyelids from Botox treating blepharospasm. Is it permanent? (Photo)

Question

I received Botox six days ago to treat blepharospasm in both of my eyes. My neurologist injected the Botox on the center of my eyelid, the side of the eye, and under the eye. He did about six shots per eye, 12 total. One eye seems to be taking the treatment fine, however the other has been drooping significantly. I noticed it about 2 days after, but it seems to be getting worse. It is absolutely devastating. How long can I expect this to last, or will my eyes stay this way forever? Please help!

Nelson Castillo, MD · Answer

Thank you for your question and photograph, and I am sorry to see your drooping eyelid.  Eyelid ptosis, or sagging, is a possible side effect of Botox administration in or around the central eyelid region.  As with all Botox treatments, the effects are temporary but there are eyedrops that can be prescribed to you that will improve your eye opening until the Botox has worn off.  With any recurrent blepharospasm, a different pattern of injection may be of benefit to avoid this in the future.  Hang in there!

Joseph Mele, MD · Answer

Blepharospasm was the first FDA approved use for Botox. Botox works by blocking the connection between the nerve and the muscle, and relaxes the muscle around the eye so that the eye can open. Judging by your narrative, some of the Botox has migrated to muscle that opens the eyelid. Since your description states that you noticed it two days after injection, it is likely that the effects will take three months to wear off. When the onset is slower, it tends to wear off faster. There are drops that may help with the appearance, but unfortunately, they are partially effective at best. It will not last forever, but it will seem that way for a while. Hang in there, it will completely resolve with time.

Martin Jugenburg, MD · Answer

Thank you for your question. Sorry to hear of this unfortunate circumstance, definitely notify your injector. This is not permanent and will resolve in approx. 3 months. All the best,

Arnold Almonte, DO · Answer

So sorry you're experiencing this complication of botox injections. Unfortunately it is a known risk, even in the most experienced hands. The most important thing to know is that it is NOT permanent. It will fully resolve once the botox wears off. There is a prescription eye drop which can help in the meantime. I recommend speaking to your Neurologist about it. I wish you the best!

William Marshall Guy, MD · Answer

Hello Elliekay,Your picture shows one of the risks of Botox, namely eyelid ptosis.  Since you were being treated for blepharospasm this risk is higher.  The good news is it will only last as long as the Botox lasts (about 3 months for most people).  There are several eye drops you can use to help raise your eyelid.  They do require using them a few times a day.  I would recommend you follow up with your neurologist who can prescribe his or her favorite eye drop for this condition. I hope this helps and good luck.

Reza Momeni, MD, FACS · Answer

Drooping of eyelids after Botox is NOT permanent, since Botox is NOT permanent.  With time, the effect goes away.  Temporary treatments can be given in the form of eye drops for patients who are good candidates.  Be sure to speak with your PS about the and hopefully within a couple of weeks, things will get better.

Gustavo A. Diaz, MD · Answer

Sorry to hear that you have this small problem. Go to your physician, this is not a permanent problem, it resolves in 3 months but there are treatments that will shorten the droopy look of the eyelid.Hope this helps,Dr. Gus Diaz

Alix J. Charles, MD · Answer

Thanks for your question. I am sorry to see you are having this well reported but unfortunate complication of Botox injections.  Rest assured this is not permanent and will likely improve to some degree after a few weeks.  The Botox will eventually wear off completely and your eyes will return to normal.  There are some prescription eye drops that may also help you temporarily with this problem while you wait for the Botox to wear off.  I suggest talking with your original injector about this problem.  Best of luck to you!

Ira Vidor, MD · Answer

Hi. Botox is the treatment of choice for blepharospasm. Injections are very effective and usually have a very high level of patient satisfaction. Since every patient is different, the exact dose and injection pattern may need to be adjusted slightly over the first few treatments in order to get the maximum result. From your photos it looks like you have developed  ptosis (a droopy upper lid) from Botox. This occurs much more frequently when the central upper eyelid is injected (as you have described). Every injector has a slightly different technique for treating blepharospasm. I generally try to avoid injecting the central upper lid due the high risk of ptosis (except for severe or unusual cases). Botox has an effect that lasts for 3 months. If your ptosis is due to Botox then it will eventually improve with time. Follow up with your injector so they can evaluate your current condition, and if they conclude your ptosis is due to Botox, they can adjust the treatment pattern next time. Best regards, Ira Vidor, M.D.

Robert S. Schmidt, MD · Answer

Thanks for your question. Botox works great for blepharospasm, but this can happen. Fortunately it will be temporary. Call your doc and let them know because they can prescribe an eye drop that can help elevate your eyelid. If you continue to have blepharospasm in the future, your doctor can adjust the pattern and amount of units to help this not to happen again. Good luck! Hang in there.

Drooping eyelids from Botox treating blepharospasm. Is it permanent? (Photo)

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