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Heavy Eyelids and Botox

Posted: 8:21 a.m. Saturday, November 14, 2015

By Anita Mandal, M.D.
Question: I had forehead wrinkles and slightly heavy upper eyelids. I got Botox from a plastic surgeon for the wrinkles, but two weeks later, my eyelids looked even heavier. When I returned to the surgeon, he said I needed upper eyelid surgery to improve the heaviness. What should I do?

Answer: A complication of Botox is actually a heavier upper eyelid when too much Botox is injected. When done in proper doses, Botox can actually improve mild heaviness of the upper eyelid. There can be a fine line between injecting enough Botox to improve heavy upper eyelids and injecting too much Botox, resulting in heavier upper eyelids.

In cases where Botox improves upper eyelid heaviness, it typically only does so when the heaviness is not severe and solely due to excess upper eyelid skin. When upper lid heaviness is due to both bulging fat and loose skin, surgery should be considered. An upper lid blepharoplasty is the surgical procedure to remove excess skin and/or fat of the upper eyelid through a fine line incision hidden in the natural upper eyelid crease.

In your case, I would wait at least 3 months for your Botox to wear off and assess how heavy your upper eyelids are without the contributing effects of Botox. If you go with your surgeon’s advice and undergo upper eyelid surgery now, your eyelids may look over-pulled once your Botox wears off months later.

As a general rule, I do not perform Botox treatments for wrinkles of the forehead and around the eyes within one month of upper eyelid surgery in order to assure accuracy in results.

Careful consultation with a Board Certified Facial Plastic Surgeon is the first step in identifying your eyelid rejuvenation needs and selecting the best options for you. It is a misconception to think you should only seek a surgeon for surgery. Facial Plastic Surgeons have in-depth knowledge of facial anatomy and expertise in both non-surgical and surgical facial aesthetic treatments. Each time you have a non-surgical cosmetic procedure by a less qualified doctor, you increase your risk of complications and poorer results. When it comes to your face, why would you consider less than a Board Certified Facial Plastic Surgeon? Log on to ABFPRS.org.

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