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How Effective is Botox for Under Eye Wrinkles?

Hi, there. I'm a 27 year old woman who has unsightly under eye wrinkles. I take pretty good care if my skin.

However, there seems to be nothing I can do to get rid of the creases under my eyes. My makeup settles in them, they are really aging me.

Will Botox help with this and if not what will? Really appreciate any help with this. Thanks

Doctor Answers 29

Don't let anyone talk you into eyelid surgery

Dear Leanne

Botox can be used to weaken the lower eyelid orbiclularis that is responsible for making the lower eyelid wrinkles. The problem is that this same bit of muscle also helps hold the lower eyelid up against the eye. Weakening this muscle may smooth the eyelid but the price is usually mild slumping of the lower eyelid margin. This is not a good trade off. Filling the lower eyelid is a good alternative. The product to use is Restylane. An additional option is an appropriate chemical peel to firm the lower eyelid skin.

Los Angeles Oculoplastic Surgeon
4.5 out of 5 stars 21 reviews

Botox and Eyes

The simple answer is: Yes!

The key is to distinguish between wrinkles as a result of movement (smiling for instance) vs at rest. Botox and Dysport help with wrinkles as a result of movement; when used correctly they can widen the eye, relax the wrinkles and give a well-rested look. Fillers can be added to correct any hollowing of the area for a better result.

The key is to be examined by an expert and have the right doses of the right material chosen and injected correctly.

Tanya Kormeili, MD
Los Angeles Dermatologist
5.0 out of 5 stars 5 reviews

Botox works only 50% of the time for under eye creases

Botox or Dysport only works 50% of the time for under eye creases but when it does it is so nice. Expect it to last 3-4 months at a cost of $300 roughly. 

David Hansen, MD
Beverly Hills Dermatologic Surgeon
5.0 out of 5 stars 31 reviews

Undereye wrinkles

Botox may not be right for you. You may want to consider laser treatments instead or fillers. Either way, you should seek an in person evaluation with a board certified plastic surgeon or dermatologist to determine what the best course of treatment is

Botox for under eye wrinkles? Yes and No.

By now you are probably aware that botox cosmetic is approved for use around the corners of the eyes, an area referred to as smile lines or crow's feet.  The approved areas for injection are lateral or outside the corner of the eye.

Despite that, we most commonly will inject the Botox more toward the area directly under the eye provided the patient meets certain physical examination characteristics to ensure this is a safe option.  We should be checking the movement of the lower lid to be sure that its strength can tolerate the relaxation of the muscles.

There are so many tools that can be helpful to influence a very youthful lower eyelid:

1.)  Skin tone can be affected by hyperactive muscles and Botox Cosmetic or Dysport can be used in this case.
2.)  General loss of volume can cause excess laxity and increasing wrinkling.  This can be treated with hyaluronic acid fillers or even a patient's own fat for transfer.
3.)  Aging skin that has lost too much elastic property and collagen content will need to undergo resurfacing to stimulate the body's healing processes.  We commonly will use peels (88% phenol), carbon dioxide fractionated, or erbium lasers to achieve this goal depending on a patients skin type.
4.)  At age 27, I would love to recommend the above to address your issues.  Surgery is probably not an option in your case but is remarkably well tolerated producing long-lasting results and so many smiling patients!

I appreciate your willingness to share your photos, but your physician really has to physically examine your eyelids to make any recommendations for you.
Best of luck with your care.  You'll do great.
Dr. Hobgood

Todd Christopher Hobgood, MD
Phoenix Facial Plastic Surgeon
5.0 out of 5 stars 28 reviews

How Effective is Botox for Under Eye Wrinkles?

It has to be done by an expert and done very precisely.
In fact less is more in the eyelid.
If you inject too much Botox the eyelid will become floppy and it will affect the way you look.
Typically a very small dose injected right under the skin and mainly in the outer half of the eyelid

How effective is Botox for under eye wrinkles?

Botox is an excellent treatment for Crow's  feet, however it cannot treat excess wrinkles on the lower lids. Botox is placed in the muscle to weaken it on a temporary basis. Botox is not placed in the extra skin. If there are excess skin present at rest( not upon animation), then a pinch technique with an incision placed at the lash line can be used to remove any excess skin. This pinch technique is then closed with tissue glue. Alternative treatments for excess skin on the lower lids include  fractionated laser resurfacing and chemical peels.

William Portuese, MD
Seattle Facial Plastic Surgeon
5.0 out of 5 stars 69 reviews

How Effective is Botox for Under Eye Wrinkles?

Botox works very well for under eye wrinkles and crows feet. From your picture it is hard to tell if you are a candidate for a lower blepharoplasty. Some fillers are also indicated in this area. 

A tough area for botox...

a small amount of botox under the eye may be helpful especially in younger individuals with good muscle tone...remember the eyelid muscles are important for closing the eyelids and too much can cause problems...only 1-2 units under the center of the lid with maybe another 1-2 just to the far side may improve your appearance without causing a droop...and if you're older, stay away from this area...

Ken Landow, MD
Las Vegas Dermatologist
4.5 out of 5 stars 9 reviews

Under Eye (Infraorbital) Wrinkles, Crinkles, and Hollows Respond Well To A Combination of Neuromodulators and Fillers

While crinkles and horizontal wrinkling under the eyes is more common with aging, there are many people who have them from youth. Regardless of age, these problems generally respond well to a combination of simple treatment approaches.

In my experience, the most effective method for nonsurgically rejuvenating this crinkly region under the eyes in a younger person would begin with the use of neuromodulators, such as Botox, Dysport, or Xeomin in order to address any muscle bulging (hypertrophy) directly under the eyes that may be contributing to the problem.

If  tear troughs are a beginning problem or dark circles, the use of the filler, Belotero Balance, combined with a very small amount of Radiesse (whitish colored injectable material) can eliminate the trough and lighten the skin. Using longer needles or cannulas than in times past, we can now enter this region from a location further down on the cheek, a method less likely to result in the bruising that used to so often temporarily result from direct injections into the troughs and hollows.

When appropriate, to further help smooth out the wrinkling under the eyes,  small amounts of Juvederm UltraPlus XC can be injected in the region of the upper inner cheek and then smoothed into place directly under the eyes along the border of the orbital rim.


It is imperative that you seek out a board certified aesthetic physician experienced in injecting the entire gamut of available materials and who is capable of tailoring a specific regimen for your particular needs.

Nelson Lee Novick, MD
New York Dermatologic Surgeon
5.0 out of 5 stars 16 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.