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Aesthetics Practice Today

Treating Ptosis After Botox Injections

Published September 25, 2012 8:47 AM by Kimberly Cray
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.



Dr. Branman,

Thank you for your feedback.  You are of course 100% correct!  There are definitely other potential side effects, of which I by no means mean to underestimate here in discussion of ptosis.  I appreciate you taking the time to emphasize that important point for patients and providers alike!



Kimberly Cray, PA-C October 2, 2012 1:21 PM
Miami FL

Ptosis in only one reason to be sure to have your Botox injections performed by a trained and qualified physician. I suggest researching the license and ability (before and after pictures, how many times the procedure has been performed, how recently) of any doctor you seek cosmetic surgery from.

Dr. Rhys Branman

Dr. Rhys Branman, Cosmetic Surgery - MD, Little Rock Cosmetic Surgery Center September 26, 2012 11:04 AM
Little Rock AR

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About this Blog

    Occupation: Physician Assistant/Nurse Practitioner
    Setting: Miami & Upland, Calif.
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