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Most 'droopy eyes' are actually droopy eyebrows due to injection of the horizontal forehead lines (as stated by Dr. Cohen). If this is the cause the droop should improve by gently lifting up the brows. You can try to improve this type of droop by adding more Botox into the brow depressors (the frown lines) and by avoiding as much being put into the forehead lines.If the eyelid still appears to be partially closed over the eyeball, then it is true ptosis and the iopidine (aka apraclonidine) drops can help till the Botox wears off.
The lag lid that can sometimes follow Botox injection into the upper lid which paralyzes a muscle which should not be paralyzed, can be offset to some degree by stimulating muscle fibers in the lid mechanism which are not affect by the Botox.
True drooping of the eyelids known as ptosis is rare after Botox injections. If this occurs, the eyelid itself does not open as much as it normally should and instead covers more of the iris than usual. This can be improved with apraclonidine drops temporarily until the condition improves, usually over the course of several weeks.Much more commonly, the upper eyelid area appears heavy due to depression of the brow. This most commonly occurs from injections in the forehead area without balancing the treatment by performing injections to the glabella and crow's feet in a patient with a predisposition to heavy brows and upper eyelids. When this occurs, Botox injections to the glabella and/or crow's feet can be helpful in some patients. In others, it may simply be a matter of time to allow the injections to begin to wear off.Always see an expert physician injector.All the best,
Prescription eyedrops that may help elevate the eyelid a couple of millimeters is apraclonidine. This helps only with eyelid ptosis and not eyebrow ptosis. Consult with your injector to determine that you truly have eyelid ptosis and what the best solution is for you. This will go away on its own over time, but it can take several weeks.
A droopy eye-LID due to Botox can be treated with Apraclonidine eye-drops which can provide a small (2mm) improvement -- Apraclonidine 0.5, 1-2 drops, 3 times per day. Make sure you put in one drop at a time, tilt your head back, and close your eyes to make sure none of the eye-drop leaks out.Be sure your prescribing physician discusses all the potential side-effects of the drops, such as "adrenaline-like" symptoms like anxiety or heart pounding; you may also experience eye irritation, eye dryness, and eye pain, amongst other symptoms. If these symptoms occur, you will likely need to take some lubricating eye drops, lower the dose, switch the eye-drops, or stop the drops altogether...Good luck.
It's not unusual for patients to request treatmentof transverse forehead wrinkles. These wrinkles are caused by contraction of the frontalismuscle which is an elevator of the brow. Unfortunately efforts to relaxthis muscle and diminish wrinkles can be accompanied by a lowered brow position.In some cases migration of botox can also result in paralysis of the uppereyelid muscles as well. This can cause a unilateral eyelid droop. These problems can becaused by both excessive botox and migration of botox. Both theeyelid and eyebrow can be affected. In most cases this resolves in two tothree months following injection without treatment. Several options exist for patientswho are unwilling to wait for spontaneous resolution of these problems. Whenbrow descent has occurred following paralysis of the frontalis muscles, it may be possible to treat the depresser muscles of thebrow with botox. Under these circumstances, elevation of the brow mayoccur. When botox injection results ineyelid drooping due to paralysis of the eyelid elevators, eye drops areavailable that partially reverse the phenomena. These include alphagen andlopidine. Both are associated with excellent clinical results andhigh levels of patient satisfaction.When this situation arises it's important to stay in closecontact with your provider.In some cases the best approach is tincture of time, while in other cases a more aggressiveapproach may be necessary.