August 30, 2016

Know this, and you will avoid eyelid ptosis after botox treatments.

Where does botulinum toxin actually go when you get an eyelid ptosis?

It’s the levator palpebrae superioris that lifts the upper lid, and it’s this muscle that is behind eyelid ptosis after a Botox, Xeomin, Azzalure or Bocouture treatment. The dreaded droopy eye symptom is easily avoided if you understand the anatomy. Depth is key, especially when you are injecting the lateral corrugator muscle while relaxing frown lines. The key to understanding the problem is to understand the anatomy from a sagittal view so that you see the depth of the levator palpebrae muscle into the orbit.

Most people assume the muscle is close to the external eyelid they see, and get nervous as they get closer to the lid.  Sadly it’s actually depth of the lateral corrugator injection as you come close to the mid pupillary line that is the risk. As you can see in the video, depth is your enemy here, as once you pass through the orbicularis oculi there is a potential path for the injected botulinum toxin to pass down into the orbit and affect the eyelid. There is more information on how to avoid this on our foundation training course here.