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Treatment Options for Botox Induced Ptosis

written by: Dr. Kristie Leong • edited by: Diana Cooper • updated: 1/9/2011

Botox injections continue to rise in popularity. Unfortunately, in about one out of twenty cases, Botox injections into the upper third of the face causes a droopy eyelid called a ptosis. What is the treatment for Botox induced ptosis?

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    More women and men are fighting the visible effects of aging by getting Botox injections. Botox injections paralyze the muscles so that dynamic facial wrinkles, or wrinkles that become obvious when the face moves, are less apparent.

    Unfortunately, when Botox is injected too close to the eyes, it can cause a ptosis, or drooping of the eyelid. This causes the eyes to look unequal in size, and if the ptosis is severe enough, it can interfere with vision in the affected eye. Is there a treatment for Botox induced ptosis?

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    Treatment for Botox Induced PtosisTreatment for Botox Induced Ptosis

    Botox-induced ptosis isn’t uncommon. According to an article published in the Dermatology Online Journal, eyelid ptosis occurs in about 5% of injections into the upper one-third of the face. Ptosis is a complication when the Botox migrates through the tissues and partially paralyzes the muscle that opens and closes the eyelid, usually as a result of injecting too close to the eye. The best treatment for Botox-induced ptosis is to not get one in the first place, but, unfortunately, it can occasionally happen even in the most competent of hands.

    If you do nothing to treat a Botox induced ptosis, it usually resolves within two to five months. This can seem like a long time if you’re forced to look at a droopy eyelid every day. On the positive side, ptosis due to Botox isn’t permanent. Over time, the Botox will “wear off" and the eyelid will return to its normal state.

    Fortunately, there is a treatment for Botox-induced ptosis. An eyedrop called Apraclonidine 0.5% eyedrops used to treat glaucoma acts on receptors that cause the muscle to contract. This helps to elevate the droopy eyelid and correct the ptosis. Not all doctors use Apraclonidine for people with Botox induced ptosis, because its use for this purpose is relatively new. When doctors use it, they usually prescribe one or two drops of the liquid into the affected eye three times daily.

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    Are There Other Treatments Available?

    According to the Dermatology Journal online, dermatologists and plastic surgeons sometimes prescribe one of two other eyedrops – neosynephrine hydrochloride 2.5% or brimonidine 0.1% -- for people with Botox-induced ptosis. These also affect the eyelid muscle and help the droopy lid to open up.

    Not all people with Botox induced ptosis will be good candidates for these drops. Some people can be allergic to one or more of them, and neosynephrine can’t be used in people who have aneurysms or narrow-angle glaucoma. Unfortunately, people who can’t use these treatments may have no other alternative than to patient wait until the ptosis resolves.

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    Treatment for Botox Induced Ptosis: The Bottom Line?

    The best “treatment" for Botox induced ptosis is to choose your doctor wisely -- one who has lots of experience doing Botox injections, preferably a plastic surgeon or dermatologist. Even so, there’s still a risk of developing a ptosis. If you end up with one, ask your doctor about one of these options.

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    References

    Dermatology Online Journal. Volume 11, Number 1.

    Medscape.com. “Botox Injections"

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