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Related Experiment Video

Updated: Jun 23, 2026

Single-stage Dynamic Reanimation of the Smile in Irreversible Facial Paralysis by Free Functional Muscle Transfer

Single-stage Dynamic Reanimation of the Smile in Irreversible Facial Paralysis by Free Functional Muscle Transfer

Published on: March 1, 2015

Unilateral ptosis: a rare presentation.

Saadia Farooq¹, Ukasha Dukht, Sulman Jaffar

¹Shifa College of Medicine, Islamabad.

JPMA. the Journal of the Pakistan Medical Association

|May 15, 2009

Summary

Botulinum toxin injections can cause temporary eyelid drooping (ptosis). This case highlights how ptosis may be a delayed side effect of cosmetic Botulinum toxin treatments, not myasthenia gravis.

Area of Science:

Ophthalmology
Neurology

Background:

Eyelid drooping (ptosis) can have various causes, including myogenic and neurological conditions.
Myasthenia gravis is a common consideration for ptosis, typically diagnosed via Tensilon testing and response to pyridostigmine.

Observation:

A patient presented with unilateral, gradual, and variable right upper eyelid ptosis.
Initial examination suggested myogenic ptosis with slightly reduced levator palpebrae superioris function.

Findings:

The patient tested negative for myasthenia gravis and did not improve with pyridostigmine treatment.
A history of recent local Botulinum toxin injection was revealed, suggesting it as the cause of ptosis.
Ptosis resolved spontaneously within six weeks after conservative management with crutch glasses.

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Single-stage Dynamic Reanimation of the Smile in Irreversible Facial Paralysis by Free Functional Muscle Transfer

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Published on: March 1, 2015

Implications:

Botulinum toxin-induced ptosis is a potential, albeit uncommon, complication of cosmetic procedures.
Differentiating iatrogenic ptosis from other causes is crucial for appropriate patient management and avoiding unnecessary interventions.
This case underscores the importance of a thorough patient history, including recent cosmetic treatments, in diagnosing ptosis.