Facial pressure, eye heaviness 2 weeks after Botox injection. Is this related?

Question

I got 20 units of Botox between my eyebrows and above each eyebrow. 2 weeks later I am having drooping and heaviness of my left eye, dryness and pressure that feels like a sinus headache, but I have no congestion and have not had a cold to indicate sinusitis. My doctor told me the eye drooping is not due to the Botox and suggested I treat my self for sinus infection. It is now 3 weeks later and symptoms persist. Any advice?

Alexander Rivkin, MD · Answer

Hello and thank you for your question.  Although rare, Botox can travel downwards into the eye muscles when injected in the glabella and cause a droopy eyelid.  A photo would be best to determine if this is the case, or if you just have a heavy brow from too much Botox.  Unfortunately if either of these are the case, you would have to wait the 2-3 month period until it wears off completely.  It is safe to say that Botox does feel the strongest the first 3-4 weeks and does tend to let up a bit.  In the meantime you can ask your doctor for specific eye drops to help lift the lid a bit temporarily.  Best of luck.

Camille Cash, MD · Answer

I'm sorry to hear of the issues you are experiencing.  Without knowing more information it's difficult to say if your Botoxt treatment is related to your symptoms, but it could be.  Typically the symptoms that you describe improve over the first few weeks if it is related.  I've included a video about neuromodulators like Botox that I hope you find helpful.

Christopher L. Hess, MD · Answer

There are two different eye droops that can occur with paralytics.  When injected into the glabellar region or the area between the eyes and injected too deeply it can effect the levator muscle or the muscle that lifts the eyelid.  So if you eyelid is lower this is the case.  The amount that can effect this muscle is less than the amount in the corrugator muscles so it won't last as long.  The other issue is if you unconsciously lift your eyebrows when your eyes are open.  This occurs in somewhat older patients.  This creates a heaviness on the eye and feels like a droop.  If this is the case it will take the entire three months to resolve.

Carmen A. Traywick, MD, FAAD · Answer

Botox lock the release of a chemical called acetylcholine, which triggers the muscle contractions that create wrinkles. Botox essentially paralyze the muscles and stops them from contracting. Results from these treatments are visible within 3-7 days with results that can last anywhere from 3-4 months. Follow up with your injector to have an in person exam. It is hard to determine without seeing before and after photos. Hope this helps.

Deborah Kessler Hudak, MD, MHA · Answer

What you describe could be related to the Botox, or to a sinusitis.  If it is due to the Botox, it will wear off in time...and then you need to request future injections be a smaller amount of Botox and (possibly) injected higher on the left forehead than they were.

Michele S. Green, MD · Answer

Botox is the most popular cosmetic treatment in my office. It sounds as if you have a droop from the Botox injections. For this reason I like to inject “baby Botox” to my patients. I would return to my treating physician for examination. It will take about two months for the effect to dissipate. For the best cosmetic results please consult an expert in Botox injections. Best, Dr. Green.

Leonard Grossman, MD · Answer

The way you described your symptoms, everything is pointing to your Botox treatment. You should speak to your treating physician about this issue. Good luck from New York City

Mohammed F. Ahmad, MD · Answer

Hello. Thank you for your question. The drooping and heaviness of your eye is most likely due to the Botox. I would go back to your injector and let them know so that they can fix it. Botox and Dysport can also cause sinus infection like symptoms. Again, I would let your injector know so that they can address the issue.

Steve Fisher, MD · Answer

It's certainly possible to experience a droopy eyelid on one or both eyes after receiving Botox injections between the eyebrows for frown line treatments.  This happens, rarely, when the Botox migrates from the injection site and has effects on an unintended muscle, in this case the one that lifts the eyelids.  There is an eye drop that can be prescribed to try and lessen the eyelid heaviness experienced; ask your doctor about this as an option for you.
Headaches can also occur after treatments with Botox, though usually would be expected to resolve after a few weeks.  Continue to keep your doctor informed of your symptoms, however, as it is certainly possible your headaches are from another cause.

M. Dawn Linn, DO · Answer

Yes, this could be from your treatment. Depending on the location of the injections, you can get your exact symptoms. Unfortunately, it has to wear off on its own time. In the meantime, it is not wrong to check with your primary care physician to be sure.

Facial pressure, eye heaviness 2 weeks after Botox injection. Is this related?

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