Botox for Migraines Leaves Woman with Near-Closed Eye, Prompting Scrutiny of Post-Treatment Care

A routine Botox treatment for chronic migraines left Lydia August with a near-total droop of her right eyelid days after the injections, forcing her to tape her eye open to drive and hindering her ability to work. August, 28, had recently moved from Florida to New Jersey and began seeing a new neurologist for the migraine therapy commonly used to reduce attack frequency. What began as a standard course of treatment soon became a concerning medical issue when the drooping eye progressed from a slight tilt to a nearly closed lid within a day or two of the procedure.

August said she could not drive safely without taping her eyelid open and that the change impaired her ability to perform tasks at work. She contacted the clinic, only to encounter a response she described as lacking in follow-up care: the receptionist told her the doctor would prescribe eye drops but did not plan to see or speak with her. The experience left her unsettled about the post-procedure support that is often crucial when complications arise.

Ptosis, or drooping of the eyelid, is a reported but relatively uncommon side effect of Botox injections. Medical expert Dr. Anthony Brissett, president of the American Academy of Facial Plastic and Reconstructive Surgery, said that ptosis occurs in about 1–5% of patients, with variation tied to where injections are placed. In migraine treatment, Botox is typically injected around the forehead, temples, and back of the head, and the risk increases when the product spreads to nearby muscles that help lift the eyelid. While August was aware that ptosis could occur, she believed her risk was lower based on prior experiences with different providers.

The eye condition has markedly affected August’s daily life. She described being unable to drive and having to work while viewing screens with one eye open, a situation she said forced her to work from home when possible. She also reported not receiving clear instructions on how often to use the prescribed eye drops, and in a follow-up TikTok post, she said she had not noticed any improvement from continuing the drops. In most cases, ptosis from Botox is temporary, typically resolving within two to six weeks as the medication wears off. Nevertheless, clinicians emphasize that compassionate follow-up care is essential during the recovery period to reassure patients and monitor evolving symptoms.

Experts stress that Botox has been FDA-approved for migraine relief for more than a decade and has helped many patients, but it is not without risks. Brissett said the best way to minimize those risks is to work with an experienced provider and have an open discussion about expectations before starting treatment, since complications can occur. He cautioned that different patients may react differently to injections, and the trajectory of any side effects can vary.

The broader context of botox-related complications underscores the need for robust patient-provider communication. While ptosis tends to be temporary, there have been reported cases where botched procedures caused more serious consequences. A Texas woman who reported botched Botox injections left her partially paralyzed and choking on her own saliva, illustrating that complications can extend beyond transient cosmetic or functional effects.

Health professionals advocating for migraine patients emphasize careful provider selection and informed consent. Patients should receive detailed counseling about potential risks, realistic timelines for improvement, and a plan for follow-up if symptoms worsen or fail to improve as expected. Open lines of communication before, during, and after treatment are considered critical to patient safety and satisfaction. Providers are encouraged to offer timely assessments or referrals if complications arise, rather than deferring care.

As August continues to recover, she remains hopeful that her situation will improve as her eye relaxes and the Botox effect diminishes. She also hopes that her experience will prompt others to seek comprehensive guidance and follow-up care when considering Botox for migraines. The case underscores that while Botox can be an effective tool for reducing migraine frequency, it is not without risk—and the quality of post-treatment support can significantly affect a patient’s experience and outcome.

Images accompanying this piece illustrate the condition described in the report and provide context for readers who want to understand the visible effects of ptosis related to Botox use.

In reflecting on the experience, medical professionals reiterate the importance of choosing an experienced clinician, asking about injection sites and techniques, and planning for a clear follow-up strategy if complications arise. By prioritizing clear communication and access to timely care, patients can better navigate the risks associated with Botox for migraine management while preserving safety and quality of life during recovery.

A nearby patient-rights advocate noted that patients should feel empowered to seek second opinions or urgent care if symptoms escalate, and that clinics should provide more explicit guidance about what to expect after treatment. As the conversation around post-treatment care evolves, both patients and providers can benefit from a shared focus on safety, transparency, and responsive follow-up—principles that are at the heart of quality health care.