Written by Tianna Manon for Avima.com

Sleepy bedroom eyes are sometimes considered attractive, but if that’s not the look you’re going for, Botox could be an option.

Many of you who are familiar with the uses of Botox may have heard that droopy eyelids are sometimes a side effect of a recent procedure. Sometimes both eyes have a little extra hanging skin, sometimes just one. Although this tends to go away on its own, many surgeons say this side effect has caused many patients to not even consider that Botox can actually also be a solution for hooded, sagging or drooping eyelids.

Overall, there are many uses for Botox. In addition to making the face appear fuller, Botox is also used to treat some muscular conditions and ease pain, including headaches and migraines. Botox works by relaxing certain muscles to allow other muscles to work unopposed. When the filler is used to treat the skin just below the brow (and above the upper eyelid) it can help with hooding. The filler can also help if you’ve lost any infrastructure in the brow area- the filler helps the muscles there pull up the skin.

For the most part, drooping lids are a purely cosmetic issue though it can cause vision problems if the hooding or drooping is severe enough.

Dr. Amiya Prasad is a New York City-based specialist who works with droopy eyelids. He says patients can personalize the procedure to fit their eyes’ needs and to adjust for the droop in each eye. He’s been using Botox in his procedures for more than 25 years.

“When I meet a patient, I try to help guide them on what the benefits and potential limits are,” he said.
He added that while he tries to give each patient the exact look they’re going for, sometimes patients’ wishes aren’t actually what’s best for them or even what’s possible. If you have severe hooding, you may have to resort to surgery, he says. It’s important to know the limits of Botox so patients aren’t ultimately let down.

Digging into the anatomy behind the work, Prasad explained that surgeons must understand the muscles surrounding the eyes before they can do this work: “When you think of the eyebrow, there’s a brow elevator called the frontalis muscle. There is also brow depressor set of muscles…by strategically injecting brow depressors you can get the eyebrow to lift. Now the question is can it lift enough to make an impact on hooding?”

Prasad says even if patients are unsure, Botox has come a long way and it’s now safer and cheaper than ever before. A consultation is a perfect way to learn more about the science and procedure and whether it can work for a patient without committing to it financially. It also allows the doctor to make sure they understand the look the patient wants. He says when consulting with patients he takes photos of them, draws on these photos the proposed work and then even has his patients sign the photos to show they understand the procedure. He encourages patients to ask their surgeon to do the same if they don’t already.

Because droopy eyelids look differently on everyone, Prasad says sometimes the cost differs as well. Some people need more than a dozen injections, others just need a few. He says it’s best to shop around and get quotes before committing to a surgeon.

Experts and surgeons agree that it’s such a noninvasive procedure, it’s at least worth getting a consultation for those considering it. Botox has come a long way and surgeons are finding new ways to use the filler that help people with every day small cosmetic issues, like hooding. Having a surgeon who is familiar with the routing is essential so don’t be afraid to shop around. Like Dr. Prasad says, you should be comfortable with your doctor and the procedure.