Botox for the first time, but I'm concerned about getting drooping eyelids. Any suggestions?

I'm looking to get Botox for the first time, but hearing horror stories of drooping eyelids and dr Spock eyebrows are putting me off, have had to consultations, first guy said to combat this he would do 3 areas, forehead, lines between eyes and a small brow lift, however second consultation I had lady wouldn't contemplate any Botox for brows and said I would just need forehead and lines between eyes, I'm confused now so any advice would be much appreciated thanks

Doctor Answers 18

Scared of Botox

I completely understand your hesitation.  It is a difficult if and where to get Botox for the first time.  First and foremost know that droopy eyelids are extremely rare. The odds of developing ptosis are on the order of one in thousands.  Additionally, while Botox is touted to last 3-4 months, studies have found that those few people who develop ptosis see it resolve in less than 4-6 weeks. Additionally, there are eyedrops that can help to treat the unwanted side effect.  I have been receiving Botox treatments for the last 4 years and have not once paused before getting treated due to the concern for ptosis and I treatment hundreds of people a year.  

My recommendation for a first time user of Botox is to start small such as the vertical lines between the eyebrows.  You can always do more; however, if you start with multiple areas treated you may never know if you would have been happy with the smaller less expensive treatments.

Finally, I would not be concerned about the possibility of "shocking" of the eyebrows.  If it develops it is easily corrected with a small touch up treatment and then future treatments can include that treatment so that it doesn't happen in the future.  

Best of luck,

Cody Koch   

Des Moines Facial Plastic Surgeon
5.0 out of 5 stars 16 reviews

Botox for the first time, but I'm concerned about getting drooping eyelids. Any suggestions?

Thank you for your question. Without seeing a photograph, it is difficult for me to recommend neurotoxin injections. I recommend that you consult with a certified injector that has the experience with the ability to educate you fully regarding the benefits and risks of such injections. I wish you the best of luck.

Botox for the First Time.

I agree with the other responses here, you definitely want to ensure you are seeing an expert injector especially since this is your first time using Botox Cosmetic. Temporary eyelid ptosis is a rare side effect, but can be completely avoided by placement of injection. There are many off label uses of Botox, and perhaps the lady you saw wasn't comfortable using those techniques. You should always return to your injector after 2 weeks for evaluation and possible re-injection for adjustments after your first time. I hope this helps you, good luck and be well!

#botoxandlines   #droopyeye   #botoxbetweenbrows

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 94 reviews

Botox and Best Results

It would be helpful if you could post a photo to best assess which area you need.  Botox when injected by an expert usually helps lift and make the eyes look brighter and larger. I would consult an expert for the best cosmetic results.  Best, Dr. Green

Botox treatment

The most important decision is choosing an experienced doctor to perform your Botox treatment.  A cosmetic dermatologist or plastic surgeon can assess your muscle movement to decide on the best treatment for you.  I advise patients to return after 2 weeks to see if any adjustments need to be done to ensure the best result.

Martie Gidon, MD, FRCPC
Toronto Dermatologist
5.0 out of 5 stars 20 reviews

Botox and droopy lids

Thank you for your question. A very small percentage of people do experience temporary eyelid ptosis after getting treated with Botox. Make sure to do your research and find experienced provider who has intimate knowledge of facial anatomy. Choosing an injector who specializes in cosmetic treatments will greatly decrease the likelihood of an adverse event, such as a droopy eyelid. 

Justin Harper, MD
Columbus Physician
5.0 out of 5 stars 14 reviews

First time Botox

Side effects are a common concern with all patients.  Make sure you seek treatment from a qualified professional.  If you are nervous, just do one area to start with.  Good luck!

Jennifer Trent, MD, FAAD
Sarasota Dermatologic Surgeon
5.0 out of 5 stars 4 reviews

Botox Side Effects

Thanks for your question. This is a question that we get asked often by our patients. The most common SIDE-EFFECTS of toxin injections include: Swelling, Redness, and Bruising at the site of injection. Complications are rare and only temporary, but may include paralysis of other nearby muscles, temporary eyelid ptosis (dropping of eyelids, 2% risk, lasts 2-3 weeks), temporary brow ptosis (dropping of eyebrows, 2% risk, lasts 2-3 weeks), cross-eyes, ectropion or edema of the lower eyelid, dry eyes, double vision, transient headaches (10%), local numbness (lasting 2-3 weeks), flu-like symptoms, rash at the injection site, pain at the injection site, infections, and bruising (need to avoid blood thinning medications). Cold compresses may be used immediately after treatment to reduce swelling only if needed. This may be applied for 3 minutes, 3 times per day, for up to 3 days. This is best done with a bag of peas in a zip lock bag. Only apply light pressure to the area. Only take Tylenol if you get a headache or migraine.  

Alim R. Devani, MD, FRCPC
Calgary Dermatologist
5.0 out of 5 stars 10 reviews

Botox for the fist time

Botox is excellent for preventing and treating frown, forehead and smile lines around the eyes.
Botox is just a tool and it all depends on the DOCTOR doing treatments.
The results can be beautiful when done properly and I would suggest to see an experienced doctor who has done many non-surgical treatments - clearly, you do not need surgery.
I hope that helps and best regards, Dr. Sapijaszko.

Mariusz Sapijaszko, MD, FRCPC
Edmonton Dermatologic Surgeon
5.0 out of 5 stars 10 reviews


What areas are being treated with Botox is completely up to you as the patient. You are not alone with the worry of drooping eyelids. As long as you visit a very experienced injector, then you should have no problems with this at all. If you are nervous, then start with one area. You can always add to it. Good Luck

Lawrence Bundrick, MD
Huntsville Plastic Surgeon
5.0 out of 5 stars 6 reviews

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.