Eyelid Ptosis! - Folsom, CA

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OH LOOK, I'm one of the lucky 1% of Botoxers who...

OH LOOK, I'm one of the lucky 1% of Botoxers who get to enjoy EYELID PTOSIS and four months of people asking if I had stroke! AWESOME! (I would roll my eyes, but, well...you know.)

For photo context, my brows are naturally low, and my right brow is naturally very slightly higher. It's a bit exaggerated now because I have to arch my right brow to keep my eye open enough to do basic things like drive a car and not walk into walls.

I got the injections on December 22nd. The droop started on the 25th ("Merry Christmas, baby! Hey, is your eye okay? Do you need to go to a doctor?!"). It's now the 30th.

For what it's worth, I plan to have a very boring New Year.

This is my first experience with Botox. I had Dysport once before and I was very pleased with the results (more about the brand switch in a moment). I'm willing to believe it was partly bad luck, but nevertheless, there were several things about this round that make me deeply uncomfortable and very unlikely to return to this practice. (I'm still considering requesting a refund.)

First, the injections are NOT performed by a doctor, but rather by an aesthetician who only comes in once every two weeks. (I should have known better, right?)

Second, when I showed up expecting Dysport, the aesthetician told me they only had Botox available. No one called to inform me beforehand--I found out as I was settling into the treatment suite. If I'd known before my appointment, I would have rescheduled. But I'd already driven a half hour during rush hour, so I told her to go ahead with the Botox. (Again, bad move.)

Third, she tried to upsell more Botox. Even at restaurants, upselling makes me uncomfortable (thanks, waiter, but I think five glasses of wine is probably enough...*hic*). It's usually a sign that the seller does NOT have your best interests at heart. I should have backed away right then.

Fourth, when I contacted the office about this, I was never offered the chance to speak directly to either the doctor or the aesthetician--only the receptionist. She relayed a message to me from the aesthetician, that I should come in for MORE BOTOX to lift my brow and fix the droopy lid. Given that my brows are naturally low and the problem is with my eyeLID, not eyeBROWS, this seemed incomprehensible.

Finally, the receptionist--yes, the RECEPTIONIST--offered to call in a prescription for Iodipine drops. She was very sweet about it, and I accepted, but at no point did she review any of the risks of Iodipine, whether I was a good candidate, or what my dosing should be. I found that troubling. I reviewed the risks and dosing on my own after the prescription was filled.

Bottom line: hindsight's 20/20 (well, right now hindsight has lousy depth perception and some blurriness from the Iodipine, but still). I seriously doubt there will be a "next time," but if there is, it will be at a more cautious practice.

Also: I'm going to try to update with photos, awful as they are, to give others a sense of how this little "side effect" plays out over time. The duration estimates are all over the charts (two weeks, depending on what you read, or three to six weeks, or maybe two months, or possibly three to four months...or FOREVER). Hopefully it'll be useful for someone in the future.

Yep, this sucks.

Well. Fifteen days post-injection and twelve days post-droop. Photo says it all.

I actually thought it looked a little better on Monday, but now that I'm comparing photographs, it literally looks unchanged. Pretty sure I'm in denial, on some level.

This pic is also twenty minutes after Naphcon-A drops. I feel like they're helping a little, but again, it might be my imagination. I'm totally willing to admit they're basically a means of coping with something that feels awful and completely beyond my control.

Also: the Iopidine did absolutely nothing for my eye, but it DID give me heart palpitations, dizzy spells, and panic attacks, among other things. So, no thanks. Done with that stuff forever.

I think the worst is the change in how I'm treated by strangers. They scrupulously avoid looking at me, as if this is a contagious condition contracted via eye contact.

I've cancelled my in-person social engagements and have started teleworking a few days a week. It feels lonely and gross. I'm trying to keep some perspective on this--I know this is temporary and, comparatively, not a big deal at all. In the grand scheme of medical complications, this is nothing.

Of course, in the grand scheme of beauty, frown lines are nothing. The universe is teaching me a lesson, right? VANITY IS BAD, STUPID.

So...yeah. Definitely not doing this Botox/Dysport thing ever again.

A bit better? Honestly can't tell .

It's ridiculous how much time I spend in front of the mirror lately, trying to answer that question.

The arch in my right eyebrow has grown more archy from using it to lift my right eyelid. I've been doing little eyebrow calisthenics on my left side to reduce the asymmetry. I hope they work, because they make me look even sillier while I'm doing them.

I've stopped driving unless absolutely necessary. I didn't realize how much this was affecting my depth perception until I nearly crashed into my husband's car while pulling into the driveway. Merging to the right on the freeway doesn't feel safe right now. Fortunately I live close to work.

I finally contacted Folsom Plastic Surgery and Laser Center and asked for a refund. They haven't committed one way or the other, but I strongly suspect they won't do it. I find that disappointing--if the incidence of ptosis is as low as it's supposed to be, then it would be easy to figure potential loss into into pricing--and it would be a strong impetus toward better injection techniques.

Not that a refund would fix this. But at least I could buy $250 worth of Ben & Jerry's to keep me company while I'm in hiding.

You can call me Winky.

Yep. Still here. Not much change.

I can ALMOST look normal if I give sexy bedroom eyes--that is, a coy smile with an upward glance. I'm not fond of doing this because I am a working professional pushing 40 and it looks like I'm trying to relive my frisky college days. Regardless, EVERYONE gets the bedroom eyes now. Deli clerks, bank tellers, homeless folks asking for cash. Bedroom eyes all around.

In other news, Folsom Plastic Surgery & Laser Center declined to give me a refund. Instead, they offered me another round of Botox, no charge.

Yeah, um...I'll pass.

A question came up in the comments that I thought might be helpful to answer up here. The question was whether I thought this was a result of the injection technique, or the change from Dysport to Botox.

The short answer is both--I think the injection technique probably caused it, but the technique was probably due to the change in product.

Here's why I think that. I called Folsom Plastic Surgery to discuss what went wrong. In the course of that discussion, I learned that the injections this round were placed farther out from my glabellar region, toward my brows.

To be clear, I did NOT request that. I'm aware I already have heavy brows and have no desire to make them heavier, so I was clear I ONLY wanted my frown lines treated.

I'm largely speculating here, but I suspect the wider placement happened because Botox supposedly "spreads" less
than Dysport--thus, in order to get the same effect I got from Dysport the previous round, the injections themselves would need to be spread out a bit more (since the Botox theoretically won't spread as much).

That necessarily put the injections closer to that above-pupil danger line--which I suspect led to the ptosis.

I can't reach any concrete conclusions, obviously, but I very much regret going forward with the Botox. I wanted the same result as the previous round, which was accomplished with Dysport. I felt very much pressured to just go with the Botox instead. I'm a big girl and I know better than to yield to pressure, but I gave in anyway, and I'm kicking myself for it.

Life lesson: assert yourself.


Not much to say. Have started driving again, and also gone back to exercising (was way too self-conscious for a while).

It's still noticeable. People still notice. It's awkward and awful and really doing a number on my self-worth. I'm trying to make a joke of it and assume the best from people, but that's hard.

Focusing on the big picture. It's temporary, and even if it weren't, there's more to life than eyelids.

About six weeks...

...and still visible, though significantly improved. My frown lines have started to show again, so I'm guessing the ptosis will be noticeable (to me, at least) for the duration of the Botox.

BONUS: If you print out all my photos in order and staple them at one end, you can make a cool DIY flipbook of Botox-induced misery!

Final Notes (Spoiler: I Survived!)

When this first happened to me I literally SCOURED this website for people who'd been through the same thing. I wanted to know WHY it happened, HOW it happened, whether it was preventable, how long it would last, how I could hide it, where I could find a nice big rock to hide under, and so on.

One of the things I noticed was that once people looked "okay" again, they stopped posting. Which was frustrating--I wanted to know how long it took for it to clear up, and if they had any lasting effects. I've gotten a lot of comments wanting the same information--understandably, because what's out there is inconsistent and often not terribly helpful

So. I'm going to do a final post here to let people know how things played out for me. Please note that this is just my experience, and yours may differ. Nevertheless, hopefully someone somewhere will take off their sunglasses and come out from under their own rock long enough to read this.

First: I'm not going to post a photo, because I basically look exactly like my "before" photo now. I literally cannot see any difference between my eyes then and my eyes now. I am SO VERY RIDICULOUSLY RELIEVED about this. I'm 16 weeks out from when the droop first appeared.

Second: the physical progress. My eye went back to "normal" at about 9 weeks, though it still visibly drooped ever so slightly when I was very tired. That "sleepy droop" cleared up at about 12 weeks. If I had to go somewhere in the late evening, I used Naphcon-A eyedrops, which opened the eyelid just enough to look normal.

Third, the "subjective" progress--that is, what my eyelid felt like. It FELT droopy for much longer. I would say that feeling didn't go away entirely until last week--so, at the 15 week mark or so. The eyelid felt heavy, and blinking it felt "slow" compared with my good eye--like it was lagging behind by a fraction of a second. Functionally, this wasn't a problem, but I did frantically check my eyes in mirror ALL THE TIME. Eyedrops didn't really help with this.

Fourth, the psychological progress. Ouch. This messed me up. I've mostly patched my friendships back together at this point, but it took some work. I'm usually a very communicative person (can you tell?) and I don't hide things from people I care about. I'm pretty direct and honest. So, when I vanished socially, my friends were VERY worried, and I didn't want to tell them what was up. It was too embarrassing. I think it made it worse that Botox is not a common thing among my circle of friends. If it were, they might be more sympathetic to Botox-gone-wrong, and I might have been more willing to open up about it. But...that's not how it is, so I didn't discuss it. At this point, we all just kind of pretend I didn't totally disappear from the face of the earth for three straight months.

I basically feel okay now. I feel like it was a bad dream. I suppose the long term effects might depend on how you handle trauma; I'm pretty resilient, and my brain likes to "block" things it doesn't like. Something sucked? Pretend it didn't happen! Yay denial!

Fifth, what I think of Botox/Dysport now: NOPE. Nope nope nope nope nope nope nope NOPE nope NOPE nope NOPE NOPE NOPE....

Sixth, miscellaneous stuff: as noted above, the prescription eyedrops made me horribly sick and did nothing to help. The Naphcon-A drops only helped a tiny bit, and were most useful when my eye was close to normal. Eye tape did nothing. Eye glue did nothing. Strategic use of eyeliner DID help toward the end; YouTube has lots of videos for folks with congenital ptosis or other asymmetry on how to hide it with eye makeup.

Finally, as I noted earlier, the place I went to did offer a free round of Botox, presumably as a customer-relations strategy, but, uh...NOPE NOPE NOPE NOPE NOPE.
Folsom Plastic Surgery & Laser Center

I was uncomfortable with several things: (1) reliance on aestheticians without doctor supervision; (2) the fact that only Botox was available when I expected Dysport, and no one informed me in advance of my appointment; (3) the upselling of additional Botox that I didn't need or request; (4) the inability to speak directly with either a doctor or aesthetician when complications arose, and the offer--made without an in-person evaluation--to "fix" it with additional Botox; and (5) the offer of prescription medication without any discussion of risks or an assessment of whether I was in fact a good candidate for it.

3 out of 5 stars Overall rating
4 out of 5 stars Doctor's bedside manner
2 out of 5 stars Answered my questions
1 out of 5 stars After care follow-up
2 out of 5 stars Time spent with me
2 out of 5 stars Phone or email responsiveness
4 out of 5 stars Staff professionalism & courtesy
4 out of 5 stars Payment process
3 out of 5 stars Wait times
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