Botox and similar medications like Dysport and Jeuveau are incredibly popular, non-surgical cosmetic procedures. These injectable neurotoxins are capable of relaxing facial muscles in order to lessen the appearance of fine lines and wrinkles. Although Botox is generally safe when injected by a skilled professional, some patients develop drooping eyelids that cause the face to look asymmetrical.
So what should you do if you get ‘droopy eyes’ from Botox? Drooping eyelids (or ptosis) is an uncommon side effect of Botox. Fortunately, it’s not a permanent one; your eyelids will go back to normal on their own after a few weeks. If you find yourself suffering from droopy eyes after your Botox treatment, it’s best to have it checked by a trusted doctor so they can prescribe eye drops to minimize your discomfort.
How Ptosis Develops After Botox
The scientific name for eyelid drooping is ptosis (or blepharoptosis). Unlike congenital ptosis -- where the eyelid droop is already present at birth -- droopy eyelids are often acquired after a bad Botox injection.
The Botox cosmetic works through its main ingredient, botulinum toxin, which temporarily paralyzes the muscles in the face. When the muscles are paralyzed, they are unable to contract and form unwanted crows feet, frown lines, smile lines, and forehead wrinkles. However, an inexperienced injector may unintentionally inject excessive Botox too close to the levator palpebrae or frontalis muscles.
The levator muscle is responsible for maintaining the eyelids in their normal position. When Botox is injected around the eyelid, the formula migrates to the levator muscle and leaves it unable to control the eyelid in raising or lowering. Eyelid drooping then occurs, causing a saggy appearance and obstructing vision in severe cases.
On the other hand, Botox injected into the forehead to reduce wrinkles may also migrate to the frontalis muscle, which is responsible for raising the eyebrows. An over-relaxed frontalis muscle can cause the brow to descend, crowding the upper eyelid and creating a droopy eyebrow. In rare cases, the only treatment option for this complication is blepharoplasty, or cosmetic eyelid surgery, to remove redundant eyelid skin.
Will The Eyelid Droop Last Long?
Droopy eyes are a rare and temporary condition. Although it can be embarrassing in social and professional situations, it’s neither life-threatening nor permanent. As Botox effects are not permanent, the problem usually reverses itself in 3 - 4 months when the Botox wears off.
During this time, however, patients may get muscle weakness in the upper eyelid. Aside from drooping, patients may also have:
- Lazy eye: Lazy eye is a condition that makes patients unable to fully open their eyes. If the droop is severe, they may have vision problems.
- Eye heaviness: Eye heaviness occurs when there is a heavy feeling in the eyelid that grows worse throughout the day.
- Lower quality of life: Because the eyes are experiencing discomfort, daily tasks like applying eye makeup may be difficult to perform.
Certain medications can be helpful in addressing any side-effects and camouflaging the droop until the Botox effects subside.
How To Prevent A Drooping Eyelid
Not every Botox patient has to suffer from droopy eyes or a sagging brow. There are ways to prevent this particular side-effect from occurring, such as:
1. Visit a board-certified dermatologist or plastic surgeon.
The first and best way to prevent sagging skin developing over your eyes is to visit a board-certified medical expert. All too often, droopy eyes happen because the injector lacks the proper training, experience, and know-how to perform the treatment accurately. They either utilize a too-high dose or inject the Botox in the wrong area.
An experienced injector would have a thorough knowledge of facial anatomy, so they can make educated decisions on the specific locations and depths to inject Botox. Prior to the procedure, a well-trained surgeon would look at the facial muscle movements of the patient to accurately map injection points to the millimeter.
2. Don’t use generic botulinum products.
Before the procedure, it’s best to check with your board-certified physician to confirm that the botulinum injections are from a well-known brand name manufacturer. Botox is only manufactured by Allergan, while other quality product is Dysport by Medicis.
All three products have undergone extensive testing by thousands of doctors and are considered the best in the market. This means they would produce more predictable results compared to no-name, generic botulinum toxin. It’s important to note that even if the injections are performed at the right Botox placement with quality solutions, there is still a very small chance of developing drooping eyelid skin.
3. Explain your full medical history to your cosmetic surgeon.
Patients who have had previous facial surgery and a history of Bell’s palsy are more likely to develop a droopy eye after neurotoxin wrinkle injections. It’s important to be honest with your doctor about your complete medical history and previous cosmetic treatments, especially those performed within the past few months. Your doctor should also check if you’re taking medication like sleep aids, allergy medicine, blood thinners, or muscle relaxants.
Your age, past sun damage, and other lifestyle factors could also affect your treatment. If there are any conflicts between your medical history and your beauty goals, your doctor may opt to postpone treatment or propose an alternative procedure, like a dermal filler, which may better suit you.
4. Follow your doctor’s instructions completely.
It’s crucial to follow pre-treatment and after-care instructions to prevent complications from occurring. Avoid rubbing or massaging your face for a full day after the injections to help stop the medication from spreading beyond the injected area.
5 Ways To Treat Eyelid Ptosis
If you suddenly find yourself suffering from eyelid ptosis, it’s important not to panic. It’s not a life-threatening problem and can easily be resolved by a qualified physician. Here are five ways you can treat droopy eyes:
- Just wait: You don’t have to do anything to correct uneven eyebrows or eyelids, as the effects wear off after 4 - 6 weeks. Of course, it depends on how much Botox came into contact with the eyelid muscle and how serious the Botox migration was in the first place. Usually, it takes less time because only a low dose reaches the muscle. However, you’re going to walk around with one of your eyes half-shut for a few weeks.
- Muscle massage: One option to treat uneven eyelids is to exercise the drooping muscle or “wake” it up. Experts recommend massaging the affected eyelid with the back of an electric toothbrush for several minutes a day; this helps stimulate the muscle and reduce the amount of time it takes for Botox to dissolve. Wait until at least a full day has passed since getting your shots before you massage the treatment area.
- Eye drops: Your doctor can prescribe a special eye drop like apraclonidine, which signals the muscle receptors to contract and raises the lid by 1 - 2 mm. Depending on your physician’s assessment, you would most likely need to apply 1 - 2 drops thrice a day.
- Botox brow lift: Adding more Botox doesn’t sound like a good idea, but injections to the depressor muscle can make your features look more symmetrical and reduce heaviness in the brow. Injecting a few units under the tail of the eyebrow can open it a little wider and counteract the excess relaxation of the eyebrow muscles. Ideally, patients should wait up to 14 days to check if they’re experiencing an eyebrow droop or weakness in the forehead muscle.
- Blepharoplasty: Sometimes, there is excess skin on the upper eyelid which cannot be addressed by neurotoxin products. If this is the case for you, an eye lift or eyelid surgery may be the best solution to remove the extra skin, reduce bags or fat from the eyes, and minimize dark circles as well. Although it may sound intimidating at first, talking to a qualified oculoplastic surgeon may be able to help ease your worries.
Is Botox Worth The Risk?
The chances of Botox patients getting a droopy eyelid from the procedure are very small to begin with, so potential patients don’t have much to worry about. The likelihood of developing brow ptosis is even smaller if you’re in the hands of an experienced Botox injector, because no other medical professional knows facial anatomy like a board-certified plastic surgeon does. You can be sure they would have the background and experience that result in the best outcomes for you. A skilled cosmetic surgeon would also be able to help minimize the possibility of developing side-effects, including:
- Teary eyes
- Blurry/double vision
Furthermore, Botox injections are the most popular form of cosmetic surgery worldwide. Millions of treatments are performed yearly and not just for aesthetic reasons either. Botox is an effective, albeit temporary, solution for medical conditions like blepharospasm, hyperhidrosis, and chronic migraines. Whether you’re interested in smoothing out wrinkles or gaining relief from physical discomfort, Botox is definitely something to consider.
Experience Safe Botox Treatments With Ethos Spa
Our number one priority at Ethos Spa is to provide every patient with a safe and effective experience. We do this by investing in the most cutting edge technologies, training, and techniques available. With our board-certified surgeon and team of expert medical staff providing their services, you’ll get the results you want with zero complications. Schedule a consultation with us today to learn more.