The most common negative reaction to injections to your face is a droopy eyelid, also called ptosis or blepharoptosis. Most people don't have this problem. Around 5% of people who get Botox will have problems with eyelid droop. This number falls to less than 1% if a skilled doctor does the injection.
Botox is a temporary treatment. The treatment can last three to seven months, but the droopy eyelids will typically go away in four to six weeks.
This occurs as a result of migration of the toxin into the muscle that raises the eyelid (levator palpebrae superioris muscle – pink in the picture). A slight miscalculation, like making the injection too low in the forehead muscle, can cause eyelid drooping after Botox.
Although ptosis may persist for the whole duration of effect of treatment with botulinum toxin type A, it will usually settle more quickly and eyelid ptosis will often settle within 3 to 4 weeks and brow ptosis within six weeks.
The next option for correction, which surprises many patients, is that you can treat an eyelid ptosis, even one caused by botulinum toxin injections, with MORE botulinum toxin! The eyelid, like most moving structures in the body has muscles which oppose each other.
Botox issues based on injection site
In that area, you generally can't make a droopy eyelid. When doctors inject into the forehead and sides of the eyes (near crow's feet), patients can start getting a droopy eyelid or a droopy eyebrow. In general, you can put about ten to fifteen units in the crow's feet.
According to Dr Gavin Chan, one of the most important things practitioners can do is to, “inject the lateral tail of the corrugator which is the muscle which causes the bunching (6.35) of the frown. Superficially injecting the lateral tail of the frown (corrugator) muscle can help avoid ptosis”.
If you are experiencing eyebrow unevenness this can also be corrected, and you do not have to wait for the Botox injections to wear off. Eyebrow unevenness can be corrected by injecting a little more neurotoxin into the side that is lower. This will eventually correct the asymmetry.
Yes, Botox can cause droopy eyelids if it is injected in the wrong place or if too much is used. Because Botox is a muscle relaxing toxin, if it is injected into the muscles that hold the eyelids or eyebrows up, then this can cause the muscles that pull the eyelids down to be more emphasised.
Eyebrow drop is so annoying to patients but thankfully the effects of Botox are not permanent. The eyebrows can start rising even before the full effect of Botox on the forehead wears off. It might take 4-6 weeks, but the eyebrow will be back to it's normal position for sure.
A qualified, experienced injector should never inject the area near the orbital bone right above the pupil. If Botox is injected here, it can drift down toward the upper eyelid and cause an eyelid droop. This can last from weeks to even months.
How long does eyebrow heaviness last? Rest assured, heavy eyebrows after Botox are temporary. The heavy sensation will completely go away once your Botox wears off in 3 months. But it usually becomes less noticeable after a week or two.
Too much Botox in the forehead muscles can cause the eyebrows to droop, making the upper eyelids look very heavy and hooded. The face may look angry or sad all the time. Too much Botox around the eyes can dramatically affect facial expression. The face is simply frozen.
What happens when you do this with a Botox treatment is that the muscle you normally use to raise your eyebrows is relaxed while the muscles you use to lower them are still active. As a result, you'll feel like your eyebrows are heavy and the position of your eyebrows may even do down.
There is a chance Botox can migrate in the first day or two after the procedure. The more Botox that is injected, the greater the risk for migration. However, experienced physicians with extensive training in Botox know how to mitigate the risk so it is extremely low.
Lid and brow ptosis from Botox usually appears a few days to a week after being injected. Usually, it gets better after three to four weeks.
Signs of a Bad Botox Injection
There are two signs you've had a bad Botox injection: Unusual results such as facial asymmetry (one side doesn't match the other), overarching eyebrows, a drooping eyelid, or not being able to move the forehead at all.
“'Some telltale signs of 'Bad Botox' are asymmetry of facial movement, excessive brow elevation and unnatural brow shape, noticeable upper-eyelid hooding, a 'frozen' look, and some lines getting smoother and others looking exaggerated,” explains New York facial plastic surgeon Konstantin Vasyukevich, MD, who offers ...
Botox onset is 5 to 7 days. Botox peaks at 10 to 14 days.
Heavy brows and the feeling of drooping.
This feeling and look comes from treatment of the forehead muscles called the frontalis. These muscles move the brows up and in certain cases after Botox treatment, the relaxed muscle then makes the brows drop.
Anti Wrinkle injections have a long track record for treating forehead lines. However, your forehead & eyelids will feel heavy for a few weeks afterwards. Your eyebrows and eyelids may also appear a little puffy first thing in the morning upon awakening but don't worry this will settle down.
In some cases, the Botox spreads to the outer portion of the muscle on one side, but not the other side. In these cases you may see only one eyebrow peaked.
Injections near the eyes pose the most risk, and these areas are commonly used to combat crow's feet and brow lines. After the Botox is injected, the eyes can become very irritated and dry, and can go quite bloodshot and red. This irritation can then increase into blurred vision and the inability to see correctly.
Treating hooded eyelids with Botox is a relatively simple process. The treatment involves injecting Botox into your lower forehead and the outer ends of your eyebrows. When injected, it will paralyze the muscle by effectively preventing nerve receptors that prompt muscle movement.
Your surgeon may inject Botox into the outside of the eyebrow, which lifts the brow and upper lid slightly. This procedure paralyzes the muscle that makes the eyebrow droop, but it leaves the muscle that raises the brow alone.