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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 (26)

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
5.0 out of 5 stars 14 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 24 reviews

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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

Naveen Somia, MBBS, PhD, FRACS
Sydney Plastic Surgeon
5.0 out of 5 stars 24 reviews

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 55 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. 

Kurtis Martin, MD
Cincinnati Plastic Surgeon
5.0 out of 5 stars 24 reviews

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
5.0 out of 5 stars 7 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 11 reviews

How Effective is Botox for Under Eye Wrinkles?


Botox works well for under the eyes.  I use about half of the normal dose for this injection.  The concern is, of course, causing the orbicularis oculi muscle to weaken and cause drooping of the eyelid.

Thomas Guillot, MD
Baton Rouge Plastic Surgeon
5.0 out of 5 stars 2 reviews

Botox for the lower lid


there is a reason why Botox has not been approved by the FDA for the lower eyelid wrinkles. It cab be a very difficult area to get a good result and the potential negative effects can be visually bad and take a long time to subside. Remember Botox works by weakening muscle and if you weaken the muscles of the lower lid, you might lessen the wrinkles, but you also might get so much weakening that the lower lid lags down, showing the white of your eye and allowing your cornea to get too dry. It might take weeks to months for the negative effect to wear off. I do not inject Botox into the eyelids for those many reasons.

Julio Garcia, MD
Las Vegas Plastic Surgeon
4.0 out of 5 stars 6 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.