I Am Worried About Permanent Ptosis From Botox

Question

I received Botox on 1/18 & today 3/29, my eyelid is still drooping a bit...it hasn't returned to normal. Years ago I had blashoplasty (upper eyelid surgery) and I'm worried that maybe it won't return to normal. (ive gad botox many times since the eyelid surgery with no prob) B4pics were taken & I was symmetrical prior to the Botox. I saw an eye doctor afterwards to rule out any other eye issues. I have had dramatic improvement from the initial ptosis, but it is not back to normal & I'm worried.

Sam Speron, MD, FACS · Answer

Hi!

	Thank you for your question.

	I would not worry about permanent ptosis from the botox treatment. The
	effects of botox are not permanent and should be completely gone from
	3-6 months after the treatment. I would suggest consulting with your
	board certified plastic surgeon.

	Good luck!

	Dr. Sam Speron

Jerome Edelstein, MD · Answer

The results of Botox wear off in about 4 months or so, and by this time your ptosis should wear off as well. I'm sorry to hear about your experience but rest assured you'll look better in a month or so.

Ron Shelton, MD · Answer

AFter three to four months there should not be any permanent ptosis after botox. I am not aware of any reports showing long term ptosis; once the Botox wears off there should not be permanent muscle weakness.

Jason E. Leedy, MD · Answer

Botox typically lasts only 3 months. It is not permanent. Any effect on the muscles will wear off after 3 months. Sometimes there can be unrecognized pre-treatment eyelid ptosis which will persist after Botox wears off but Botox will not cause permanent changes.

Kenneth D. Steinsapir, MD · Answer

In every case, the ptosis fully resolved even it persisted for many months. However, in a few people it was clear that they had ptosis before the botox treatment and did not pay attention to the ptosis. We know this by studying the before and after photos. If you had ptosis before botox, do not expect the eyelid position to resolve to a position that is higher than it was before the botox treatment.

Barry L. Eppley, MD, DMD · Answer

Any eyelid drooping effect caused by Botox will completely resolve. There are no known cases where the undesired effect of upper eyelid ptosis after Botox injections did not completely resolve. It is just a function of time.

Matheson A. Harris, MD · Answer

Most cases of droopy eyelid (ptosis) after Botox resolve in a few weeks, but if a large enough amount of the toxin made it to the eyelid muscle (levator) it could last 3-6 months. As has been mentioned, I've never seen a permanent ptosis from Botox. In fact, we often use Botox to cause ptosis in patients who have problems closing and protecting their eyes. Invariably, they have to come back every 3 months or sooner for repeat injections because it always wears off.

Edwin Ishoo, MD · Answer

If you are experiencing new onset ptosis of the upper brow after your last Botox injection it would be highly unusual for it to last more than 6 months let alone be permenant. The attenuation of the frontalis muscle effect on elevation of your brow is temporary and I know of no cases of permenant ptosis or muscle weekness after Botox injection. I suggest following up with your provider and being patient. It will likely begin to improve and resolve over the next 2-4 months.

Francis R. Palmer, III, MD (retired) · Answer

I have used neurotoxins like Botox, Dysport and the newer Xeomin for over 22 years and have been permanent.

Richard W. Fleming, MD (retired) · Answer

There are no documented cases where ptosis after Botox injections was permanent. Be patient; your present problem will be temporary.

I Am Worried About Permanent Ptosis From Botox

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