Lydia August has been receiving Botox injections to treat chronic migraines for three years, but her most-recent dose didn’t go as planned.
The 28-year-old, a senior marketing director from New Jersey, recently went viral on TikTok after experiencing a rare adverse reaction: her right eyelid became completely shut and will not open—a condition known as eyelid ptosis.
“I have no pain on the affected eye, just a heavy feeling, which can be uncomfortable sometimes,” August told Newsweek.
What Is Ptosis?
Newsweek reached out to Dr. Keiron Lord, an aesthetic doctor and founder of the Dr Lord Group, a regenerative and esthetics clinic in Manchester, England.
“Eyelid droop, or ptosis, is a known but rare side effect of Botox,” Lord said. “It happens when a small amount of the product moves from the injection site and temporarily affects the levator palpebrae superioris muscle, which is responsible for lifting the eyelid.”
The Allergan Aesthetics website says the company—a global division of the biopharmaceutical firm AbbVie—develops, manufactures, and markets products for the aesthetic medicine industry. The most-common side effects of BOTOX® Cosmetic differ depending on the treatment area. For glabellar lines, reported reactions include eyelid drooping (3 percent), facial pain, facial muscle weakness, and overall muscular weakness (each 1 percent). For lateral canthal lines, or crow’s feet, eyelid swelling occurs in about 1 percent of cases. When treating forehead lines together with glabellar lines, headaches are most common (9 percent), followed by brow drooping and eyelid drooping (each 2 percent).
Lord added: “It’s important to stress this isn’t usually anyone’s fault. Even with the best technique, there’s always a small risk when treating the forehead or frown lines. Practitioners can take steps to reduce the chance, but it can’t be avoided completely.”
A Gradual Onset
August claims she received the treatment on September 10 and “has not shown any improvement” after 12 days. Initially, her right eye was “slightly droopy but not super noticeable” after two days.
“Then, on the third day, my eye was halfway closed and, by the next day, my eye was pretty much completely closed,” August said. “This happened over the weekend, so I was not able to reach out to my doctor immediately.”
Lord, who is also a general practitioner, said that the condition is temporary: “The good news is it isn’t permanent—it wears off as the Botox does,” he said. “In the meantime, it can sometimes be eased with apraclonidine 0.5 percent eye drops, which work by stimulating a different eyelid muscle to give a slight lift. People also tend to compensate naturally by raising their eyebrows.”
August said she has tried recommended remedies but added that nothing has worked.
“There are ways to attempt to fix the drooping, but I have exhausted my options. Most options can help with a mild to moderate droop—mine is extremely severe. At this point, I am just going to have to wait for the Botox to run its course and wait for my body to fully metabolize it before it goes back to normal,” she said.
Finding Humor Amid Frustration
Despite the setback, August has found ways to keep her spirits up. In a popular TikTok video (@lydiaaugust), she joked: “Catch me winking at you for the next 12 weeks.” This was followed by another eye update that has since gained more than 417,000 views.
During the video, she manages to see the good side and says that her visual impairment means she can work from home.
August told Newsweek: “My good eye is becoming dry, strained, and feeling overused because it has to compensate for the fact that my other eye is not being used.
“I cannot drive, enjoy life, and working is very difficult. I have had to tape up my bad eye, just to give my good eye some relief.”
TikTok Reacts
Many viewers shared their own experiences with Botox-related eyelid drooping. One user commented: “This happened to me too. It took about 3/4 months to feel somewhat normal and honestly 9 months until I didn’t have a lazy eyelid.”
Another said: “Gotta’ go to a provider who injects Botox all day every day, people think surgeons or derms are the best people to go to but if they mostly do surgery or other medical tx [treatment], trust me—your results may vary.”
August responded, saying that her injections were for a medical reason: “I see what you’re saying and for cosmetic reasons I would totally go to a reputable injector. Unfortunately, since this was for migraines I had to get it done by a neurologist.”
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