Can Botox Cause Permanent Eye Muscle Damage?

Q: Dr. Eppley, I had upper and lower eyelid surgery and a muscle needed to be stitched in my eyebrow where a cut injury once existed. I have just had Botox for frown lines. The doctor (different doctor) hurt me when injecting into that muscle. Within a few hours my eyelid is heavy, dropped eyebrow and when I raise my cheek in a winking jesture the whole of my cheek quivers very badly. Will the effect of the Botox go away and the lid raise? Does this sound permanent? Has the muscle been damaged by the Botox as it was scared tissue and stitched in 2008 in order to raise the eyelid? I would be so comforted by your response as I need reassurance before i return to my doctor for correction.

A: The workings of Botox is based on two fundamental principles, it affects the neuromuscular junction of the muscle causing weakness or paralysis and its effects are TEMPORARY. The biggest advantage and disadvantage to Botox is that its effects are not permanent. Patients who get good results with its use wish it was permanent while few patients who develop an undesired aesthetic effect are happy that it is only temporary. In addition, Botox has no adverse effect on long-term muscle function regardless of whether it has had prior surgery on it or not.

Dr. Barry Eppley

Indianapolis, Indiana