Cosmetic Surgery Excellence

Botox Q & A #2 – Realself

Q: Eye shape after Botox. (photo)

I know it’s time for Botox when I wake up with a crease in between my eyes. 3 weeks ago I got Botox from a place I have gone to for several years. My mascara is now rubbing off ony upper lid bc the lid is heavy. My right eye is now shaped differently. I hate it. I went back and she injected a small amount above my arch, but it is a week later and the eye does not look any different. Also I am still waking up with a crease trying to form. I am so self-conscious. Can anything be done?
Asymmetrical eyes after botox

A: The primary problem is you need an upper eyelid blepharoplasty- risk of paralytics/Botox

The paralytics- Botox, Dysport etc., all have a risk of causing too much sagging of the upper eyebrows which results in the manifestation of the excess eyelid skin.  The eye brow asymmetry will go away when the paralytic wears off.  This is a risk of the injection and it does not mean the doctor did something wrong it just means that the paralytic extended more laterally than you are used to.  Few people will notice the problem as much as you do.  It is likely that if the injection was done by the same person, they injected in almost the same place as always so the lateral droop may be from some that has leaked to the side more than normal which means it may not be as strong a paralytic as the rest of the treatment areas, so it may resolve quicker.  Looking at your eyelids, you have so much excess skin, you would benefit from upper eyelid skin removal which is called a blepharoplasty.  This need is frequently made more visible by the paralytic because your natural tendency to lift the brows subconsciously in order to get the excess skin off your lid is not functioning with the paralytic on board.  The weight of the excess eyelid skin is part of the reason you have presented for the paralytic in the first place because with out the excess skin you would not lift your brows which has caused the wrinkles.  This is a wonderful surgery and done as a straight local procedure.  Sutures are removed in 3-4 days and the results last for many years. Having this procedure will reduce your need for the paralytic and make your eyelids look better with and without the paralytic on board. Good luck- just wait it out- it is still worth the paralytic cuz the wrinkles look much worse.

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