Botox and Eyebrow Drooping

Q: Hi Dr. Yang,

Haven’t join this board for a long time. I had botox 7 days ago. One of my eyes is drooping.
I look angry. Terrible. One wants to look better and then this.
I want to get rid of botox. Would a massage and hot compress get rid of this ?

I am going to see the doctor who injected this this week? I well informed him I had eye drooping due
to eye bleph years ago.



A: Hi MaryNicole,

Botox takes about two months to begin wearing off, and 4-5 months to fully wear off. At the two month mark, you should get about 50% of the muscle strength back. Massage and warm compresses will not get rid of the effects of Botox faster. Luckily, the effects are temporary, but if you don’t like the way the botox was injected this time, be sure not to get the same pattern of Botox injection the following session, or choose not to have Botox at all.

There are two types of eyelid drooping. Upper eyelid drooping can cause hooding and the excess skin on the upper eyelid/brow to touch the eyelashes, while drooping of the lower eyelids is entirely different. Drooping from lower eyelid surgery causes the lower eyelid to pull down and show too much “white of the eye” also known as sclera. This is also called scleral show. In extreme cases of lower eyelid drooping, the lower eyelid can pull away from the eyeball itself, and the eye is at risk for drying out, too.

One additional type of eyelid drooping can be caused by Botox, and that is called Ptosis (AKA blepharoptosis, where the upper eyelid can’t open all of the way, and the upper eyelid covers part of the pupil.) This happens when the Botox paralyzes the eyelid opening muscle called the levator aponeurosis. It is a rare occurence, but with the newer Botox called Dysport, has a tendency to spread further from the area it was injected. It can be helpful for some areas we might want an even coverage, but for injections close to the upper eyelid, there may be a slightly higher risk of Ptosis. This is another possibility.

Based on your description, I don’t know which of the three types of drooping you are referring to. The best thing you can do is contact your Botox injector to discuss the Botox injection results with him or her. If there is a problem with any procedure, the surgeon or doctor who performed it should be informed and given a chance to explain what happened and have a chance to remedy the problem. If the patient does not want to let the doctor know there was a problem, the doctor will likely think everything went great as usual.

Your injector will have notes on how much Botox was injected and to what area. In some cases, more Botox could be injected to “balance out” the eyelids and make them look the same. But, the more likely option is to just wait for the Botox to wear off.


Dr. Yang