Will Botox help lift my inner eyelid?

Another public forum question I attempted to answer.  This question comes from Corona, California.  A photo was attached, but it isn’t entirely clear from the non-moving 2D photo – the goals and wishes of the patient.  But I did my best to try to answer the question.

 

Here’s my answer which all the other doctors don’t seem to understand what I’m writing:

Lateral and Medial Pretarsal Obicularis Botox micro injections

What we’re discussing is consider off-label FDA use of Botox.  In my experience, I have treated only 3 patients for eye lid raising with Botox.  The injections are extremely tricky.

I would inject the lateral and/or medial aspects of the pretarsal obicularis (which is the eyelid muscle) – taking extreme care to avoid the middle part of that muscle which is connected to the levator (which lifts the eyelid).  I would inject about 0.5 to 1 unit with each shot.  I don’t want to go into too much detail because this is a discussion you need to have with your injector.  The basic theory is that if we weaken a depressor (which are the sides of the eyelid), we help the levator become more dominant.

For mild imbalances in appearance, I would leave it alone.  It’s possible for us to make things worse with our decisions and injections.  With my only 3 patient trial of this method – this doesn’t make me the expert on this topic.  It’s a very rare request.

Basically if your question was an academic style question, I would say that it could be done if I understood your question correctly.  But in reality – check with your Botox injector!

Thank you for your question. Without having seen you in person, I’m answering the best I can without physical examination info. My comments are meant for a general public discussion to help others who may have similar concerns. I’m also using my answers to build up library of information for my own patients and also to see how my answers compare with other doctors. There is always much for us to learn from each other. My answers are generalized medical information only, not directed medical advice. For medical advice please see your doctor/surgeon in person.

Best wishes.

Calvin Lee, MD
Modesto Botox Injector, California