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. Another ten to fifteen units in the forehead.
In most cases, droopy eyelid occurs between one and three weeks after treatment, and patients typically experience this adverse effect for just a few weeks. According to Dr. Holman, “It's important to remember that, like Botox treatments, a drooping eyelid is usually temporary. The effect will wear off after a while.
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.
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 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.
Effects of neurotoxin injections (Botox, Dysport and Xeomin) peak between 3 and 7 days with 5 as the average. You would expect ptosis to occur by that time if it's going to happen at all. Having the Botox injected by an MD that understands and follows the proper aesthetics of facial beauty also help IMO.
One common treatment is an α2-adrenergic agonist ophthalmic eye drop, 0.5% apraclonidine. Another selective α2-adrenergic agent, brimonidine eye drop, is used as an alternative to apraclonidine to treat eyelid ptosis.
Eyelid ptosis is most commonly seen from inappropriate placement of botulinum toxin. This specific complication can be avoided by staying at least 2‐3 cm above the supraorbital margin or 1.5‐2 cm above the eyebrow while injecting into the frontalis.
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.
Unfortunately, as the full results from Botox injections will take up to two weeks to appear, there is a chance the drooping could get worse. However, as the results from Botox are only temporary, the droopiness should completely resolve over the next three months.
If the Botox is placed too low or if it migrates down, the Botox can affect the lower part of the muscle and cause a droopy eyebrow. Sometimes when your eyebrow goes down, it can make your upper eyelid heavy too, making it look like droopy eyelids.
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.
Typically, an oculoplastic surgeon may prescribe an average dose of 12 to 24 Botox units for treatment around and under the eyes.
Drooping of the eyelid is called ptosis. Ptosis may result from damage to the nerve that controls the muscles of the eyelid, problems with the muscle strength (as in myasthenia gravis), or from swelling of the lid.
Ptosis explained
Mild ptosis affects only one eyelid, making it noticeably different from the unaffected eye. When it affects both eyelids, your condition may be less obvious. Moderate-to-severe cases can cause excessive eyelid drooping that leaves most of the upper iris and a significant portion of the pupil covered.
Eye brow drop is one of the most common complications of Botox injections. We have few patients that come new to the clinic that ask us specifically to be careful with the eyebrow as they had them dropped before from previous injectors.
Because the frontalis muscle is an eyebrow elevator, placing too much product too far laterally in the forehead can entirely block the frontalis muscle and lead to a droopy eyebrow. In patients who are younger, typically in their mid-30s to early 40s, usually this is not a significant consequence.
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.
Between 10 to 50 Units of botox
A forehead botox injection can require between 10 to 50 units needed in the forehead depending on the severity of your wrinkles. Allergan, the manufacturer of Botox suggests the amount of units that's recommended in the “five” sites of the forehead is 4 units.
How many units of Botox are allowed on the forehead? For horizontal forehead lines, practitioners can inject up to 15–30 units of Botox. For “11” lines between the eyes (or glabellar lines), up to 40 units are indicated, with higher doses needed in male patients .
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.
Botox is a great facial injection and can "open up" the eyes and make you look more refreshed. However, if Botox is injected too low in your forehead it can make the eyes appear smaller and cause lid "heaviness". The results will last about three months and get much better over time and will not be permanent.
Answer: Will Massage Make Botox Go Away Quicker? I'm very sorry you are experiencing unfavorable reactions to your Botox treatment. The unfortunate news is massaging will not change the longevity of the Botox; however the good news is the effects should soften soon.