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I am having BOTOX treatment complications and my wedding is in two weeks. What do I do?

Published on October 23, 2011

BOTOX® complications can range from minor problems like bruising, frozen forehead, or swelling, to more severe problems like eyelid ptosis, to the even more rare systemic effects including difficulty swallowing. Typically, even these more severe problems will resolve themselves over a period of 4 to 6 weeks without intervention. However, given a very short time frame, it is essential to see a treating physician immediately to determine the best course of action.

Fixing Minor Problems

BOTOX treatments are popular because they are noninvasive and effective in relaxing tense muscles and smoothing wrinkles. BOTOX is a naturally-occurring purified protein that relaxes muscles but is eventually broken down and expelled from your body completely. The effects usually last 4 to 6 months.

With botulinum toxin A products (BOTOX, Dysport, Xeomin), adverse issues are usually the result of an unbalanced treatment. Forehead treatment can be associated with upper eyelid or eyebrow ptosis. Unbalance forehead treatment can result in issues of asymmetry. It is possible to improve your treatment results using the appropriate counter treatment along the eyebrow using Dr. Steinsapir’s Microdroplet method.

Eyelid Ptosis

If your BOTOX treatment has caused eyelid ptosis, Dr. Steinsapir recommends finding an oculoplastic surgeon to help you with this particular issue. Oculoplastic surgeons are trained to assess and treat upper eyelid ptosis. A prescription for Iopidine (aproclonidine ophthalmic solution) can be helpful in this circumstance; this medication is a glaucoma drop that can elevate the eyelid a couple of millimeters. The drops can also be used to assess the severity of the ptosis and predict the likely time frame for the resolution. Dr. Steinsapir recommends trying the drops twice a day for a week. If successful in opening the eye, the ptosis will likely resolve in 4-6 weeks and the drops will help improve the eyelid ptosis until resolution takes place.

The likelihood of upper eyelid ptosis is extremely small in the hands of an experienced injector. Less experienced injectors are more likely to perform a treatment that causes ptosis. It’s important to carefully research a doctor or nurse’s credentials and their track record for successful injections. The individual performing your treatment has a profound effect on the risk of side effects. Upper eyelid ptosis has been reported in as many as 5% of cases. The incidence of upper eyelid ptosis in the hands of experienced injectors is much less. Dr. Steinsapir has seen only three mild cases of ptosis in his last 3,500 treatments.

Other Options

What if your doctor tells you that there are no treatment options? Rescheduling an event like a wedding can be impossible. Consider having a heart to heart with your photographer. Can they photograph you to minimize the appearance of a droppy eyelid or photoshop your images after the fact? If so, consider going forward with your plans and let the photographers cure your eyelid position digitally.

About Dr. Steinsapir

Dr. Steinsapir is a much sought after oculofacial surgeon. He is an innovator in minimally invasive cosmetic and reconstructive procedures and has invented new methods for treating with BOTOX, Fillers and cutting edge reconstructive eyelid and midface surgery. He specializes in high precision eyelid surgery and is a leader in correcting prior facial and eyelid surgery, including multiple revised cosmetic eyelid reconstructions. He attended medical school at the UCLA and completed ophthalmology residency at The University of Chicago. He is multiple fellowship trained including three years of fellowship training in oculofacial plastic surgery at UCLA, and a two-year cosmetic surgery fellowship in Rancho Mirage. He is widely published and lectures to other surgeons nationally and internationally. He is an associate clinical professor of Ophthalmic Plastic and Reconstructive Surgery at the Jules Stein Eye Institute at UCLA. His private practice is located in West Los Angeles, immediately serving the Los Angeles and Bevery Hills communities. Additionally, individuals from all over the country and the world regularly come to Los Angeles for his expert care.

To learn more about Dr. Steinsapir’s specialized BOTOX treatments, please contact us today.

Services described may be “off-label” and lack FDA approval. This article is informational and does not constitute an advertisement for off-label treatment. No services should be provided without a good faith examination by a licensed physician and an informed consent with a discussion of risks, benefits, alternatives, and the likelihood of treatment success. Only you and your treating physician or surgeon can determine if a treatment is right for you.


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