# *Ptosis* – drooping lid.

> Ptosis after Botox explained: lid ptosis vs. brow ptosis, how it happens, frequency, what helps (eye drops, time)

- Source: https://www.vivaderm.de/lexicon-ptosis-en.html
- Language: en
- Publisher: VIVA DERM, Privatpraxis für ästhetische Medizin, Rosastraße 6a, 45130 Essen, Germany, +49 1520 8367711
- Responsible physician: Katayoun Mostaghimi (Fachärztin für Allgemeinmedizin)
- Updated: 2026-10-05

A temporarily drooping upper eyelid or lowered brow after botulinum toxin – rare, through diffusion into the wrong muscle. Resolves within weeks.

## A closer look.

Two forms are often confused. Brow ptosis occurs when the forehead is treated too strongly or too low: the frontalis can no longer lift the brow and the lid looks heavy. True lid ptosis is rarer and occurs when substance diffuses from the glabella region into the lid-lifting muscle – usually visible within the first two weeks.

Both forms are temporary: brow ptosis eases after four to eight weeks, lid ptosis usually after two to six weeks. For lid ptosis, eye drops with apraclonidine can lift the lid by one to two millimetres until the effect wears off. The frequency with experienced practitioners is below one percent.

Prevention: glabella injection points at least one centimetre above the brow edge, an adjusted dose in the forehead, staying upright for four hours afterwards and not massaging the area. Anyone with a low-set brow before treatment deliberately gets little or nothing in the forehead.

This lexicon entry is general information and does not replace the medical consultation required under German law (§ 630e BGB).

## At a glance.

- **Brow ptosis:** forehead overdosed; 4–8 weeks
- **Lid ptosis:** diffusion into lid lifter; 2–6 weeks
- **Frequency:** < 1 % with experience
- **Help:** apraclonidine drops, time

## Frequently asked questions.

**Will the lid stay like this forever?**

No. Both forms resolve completely as the substance is broken down.

**What to do if it happens?**

Tell the practice. For lid ptosis eye drops can be prescribed; otherwise patience helps.

## Related pages.

- [Botox forehead](https://www.vivaderm.de/botox-forehead-en.html) – Treatment
- [Glabella](https://www.vivaderm.de/lexicon-glabella-en.html) – Lexicon
- [Aftercare](https://www.vivaderm.de/guide-aftercare-en.html) – After treatment

## Sources

- [NHS: Botox injections – patient information](https://www.nhs.uk/conditions/cosmetic-procedures/non-surgical-cosmetic-procedures/botox-injections/)
- [DGBT – German Society for Aesthetic Botulinum Toxin Therapy](https://www.dgbt.de/)
- [BfArM – Federal Institute for Drugs and Medical Devices](https://www.bfarm.de/)
- [European Medicines Agency (EMA)](https://www.ema.europa.eu/)
- [§ 630e BGB – duty to inform before treatment (German Civil Code)](https://www.gesetze-im-internet.de/bgb/__630e.html)
- [AWMF – German clinical practice guidelines](https://www.awmf.org/)

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This page is general information and does not replace medical consultation and informed consent (§ 630e BGB). No guarantee of results. Prices are guide prices per GOÄ. Quoting with attribution (VIVA DERM, Essen) is expressly permitted.