I Have the Drooping Eyelids After Botox and my Doctor Prescribed a Medrol Doe Pack- Is This a Good Choice?

Hi Cheryl.  The panel has about as much confidence in your MD as you do.  Obviously he's missing something and does not seem very experienced with Botox injections (which would explain why he dropped your brow and eyelids).  Ptosis is a heaviness of the eyelid and/or eyebrow.   Lopidine can help with the eyelids, but there will be a few weeks at least until things are back to normal.  At worst the ptosis can be present for 2-3 months.

The disturbing issue is why he would have prescribed the Medrol dose.  Not a good indication of his capability and knowledge.  

Unfortunately without photographs and without examining you in person which includes a thorough history and allergy check, it is difficult to comment on your condition.  If you have a true allergy with swelling in addition to droopy eyelids, I can see how a Medrol dose pack may have been prescribed.  Typically, droopy eyelids may be treated with Apraclonidine eye drops albeit not always with any significant improvement.I would recommend seeking a second opinion from a licensed physician who is experienced in Botox administration, and understands how to treat possible complications, such as eyelid droop.Good luck.

Without knowing your exact condition, nor examining you in -person and not knowing your history, no doctor can comment via the internet on your treatment with precision.  In general, the chance of developing an allergic reaction to Botox is extremely rare and not seen by most doctors.  If there is a swelling reaction, in which fluids are retained, then an antiinflammatory agent such as a medrol dose pack of corticosteroids may help reduce this faster than antihistamines, but there are side effects and risks with corticosteroids.  Furthermore, a droopy eyebrow may push the upper eyelid down after Botox relaxes the forehead muscle and the "extra" tissue underneath the eyebrow and above the eyelid could make it seem puffy but it is not fluid, but just the tissue hanging.  This makes it difficult for women to apply eye shadow and if excessive, especially in patients who already see sagging upper eyelids, they may notice that their upper field of vision is blocked by the lower eyelid.  It may take 12 to 16 weeks or more for this to improve.

The Medrol dose pack will be a complete waste of money.  It has absolutely no role in treating upper eyelid ptosis after BOTOX.  The eye drop that can help is Iopodine or Aproclonidine ophthalmic drops.  I recommend a one week trial of these drops.  If the eyelid positions improve on the drop, it suggests that the ptosis will resolve within a 6-8 week period.  If the eyelid position does not improve at all during this week of trial, then is suggests the paralysis of the muscle responsible for raising the upper eyelids is more severe and can take 3-4 months to resolve and sometimes longer.  During this time it is appropriate to try the drops one a week.  As soon as they become effective, this foretells a 6-8 week time frame for resolution.  During the 6-8 week period regular use of the drops will help keep the eyes open.  I suggest seeing an oculoplastic surgeon for management of the ptosis.  I am sorry you are experiencing this complication.

Droopy eyelids following Botox treatment are often due to overtreatment of the frontalis, your forehead muscle.  This muscle is responsible for keeping your brow (and upper eyelid) in proper position.  If it is truly eyelid droopiness, prescription eyedrops (aproclonidine) can be prescribed.  In my experience, oral steroids would not be first line treatment for your concern.