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Britney Spears’ recent Instagram post is doing double duty: part personal confession, part inadvertent PSA about a Botox side effect many people don’t know about. In a video posted August 7, the singer said a recent Botox appointment left her left eyelid visibly drooping for nearly a month\u2014a textbook case, dermatologists say, of a well-documented, low-risk and fully reversible complication called ptosis.<\/p>\n
Denver, CO dermatologist Joel L. Cohen, MD says the condition is nothing to worry about\u2014it’s both rare and reversible. \u201cEyelid ptosis (droop) is a known risk after Botox in the upper face, at about 1-percent in most clinical studies when the area between the eyebrows, or the glabella, is treated,\u201d says Dr. Cohen, who has published, as lead-author, one of the largest academic textbooks on Botox and other botulinum neuromodulator agents for plastic surgeons, dermatologists and aesthetic physicians. \u201cThis is a well-known entity that’s thoroughly reviewed in every textbook, paper and clinical trial on Botox and its competitors.\u201d<\/p>\n<\/div>\n
As Dr. Cohen explains, eyelid ptosis can happen (in rare cases) if the injection liquid diffuses to a muscle in the eyelid that functions to lift the upper eyelid upwards, which is called the levator palpebrae superioris muscle. \u201cIt is important that this is differentiated from eyebrow ptosis, which occurs when the forehead muscle that lifts up the brows is overinjected in some people.\u201d<\/p>\n
\u201cFor experienced injectors, the risk of eyelid ptosis is usually even lower than 1 percent, but still not zero,\u201d he adds. \u201cExperienced injectors know about this entity, know it can rarely occur and, most importantly, know how to minimize it with specific drops to be much less apparent\u2014as the condition gradually resolves over several weeks.\u00a0In this eyelid ptosis case, at minimum, her injector should have known about iopidine drops and how they work. It\u2019s obviously best <\/em> if your injector has a license to prescribe medications like these prescription drops to help improve the situation until things resolve.\u201d<\/p>\n Spears’ own four-week timeline tracks almost exactly with that recovery window, but Dr. Cohen warns the answer isn’t to do more Botox to treat a case like this. \u201cWe only routinely do that for brow ptosis to decrease the lateral and top of the muscle around the eye [called the orbicularis oculi muscle] from pulling down the outer aspect of the eyebrow.\u201d<\/p>\n There’s no way to prevent every possible side effect, Dr. Cohen says, and his advice applies whether you’re sitting in a board-certified dermatologist’s office or a medspa chair. \u201cBut minimizing risk is what folks should want and seek. It’s important for patients to ask their injector about their experience, and they should have a lot more than just a weekend-course certificate. They should have years of education like a medical residency where anatomy and aesthetic procedures are taught and re-taught, and then routinely tested.\u201d<\/p>\n \u201cIt\u2019s also important to ask if your injector has the ability to write a prescription, in case a complication occurs, or, at the very least, has an on-site physician or access to one available at all times.\u201d He adds that a prescribing injector also needs a full picture of a patient’s other medications, allergies and health conditions to avoid dangerous interactions or side effects.<\/p>\n His reassurance for anyone nervous about trying Botox: \u201cFortunately, eyelid ptosis after botulinum injection treatment is extremely rare, not serious and will resolve on its own, but it can definitely be minimized with prescription eyedrops.\u201d All of which is to say, don’t let one viral video scare you off Botox for good.<\/p>\n<\/div>\n