Treating Ptosis After Botox Injections
Eye ptosis, or drooping of the eyelid or brow, is a potential side effect of Botox treatment. It is among the most common side effects associated with botulinum injections, although it should not occur frequently with proper injection technique. It is beneficial for patients and providers to know the proper antidote.
Since Botox is not permanent, the ptosis will resolve over time, even without treatment. While Botox usually lasts approximately 4 months, if left untreated ptosis does not typically last that long. Proper treatment for correction is with Iopidine (apraclonidine) 0.5% drops. Apraclonidine is an alpha2- adrenergic agonist, which causes the eyelid muscles to contract. For mild cases, patients could also try over-the-counter Visine drops with phenylepherine. Use 1 to 2 drops three times daily in the affected eye until the ptosis resolves.
There are many specialists performing Botox treatments now (including OB/GYNs, dentists and primary care providers), but it really should be performed by an aesthetic specialist with proper training. Make sure to evaluate patients for any asymmetry or ptosis prior to treatment. Some patients may have a subclinical ptosis that is not obvious before treatment. When the frontalis muscle is injected in this case, drooping may occur because the forehead muscle compensates for the weakened eyelid muscle.