Eyebags Worse After Botox?

Botox is a wonderful treatment for crows feet--those lines that extend radially from the corner of the eye when smiling. Botox relaxes the muscle that surrounds the eye, which results in diminished wrinkling of the skin when one smiles.
I have seen, in a few patients, excellent results from Botox in improvment of the crows feet, but accentuation the wrinkles under the eyes. In select cases, Botox can be placed under the eye, but this may result in lowering of the eyelid rim. Sometimes I have recommended that these patients stop receiving Botox to the crows feet due to accentuation of the wrinkles under the eyes. Occasionally, I recommend a chemical peel to the skin of the lower lids to improve these wrinkles. Treatment is really tailored to the individual's needs and orbital anatomy.

Dear Sara
This is absolutely reported. The botox injected for the crows feet area can drift, weakening the orbicularis oculi muscle below the eye in the outer lower eyelid. This causes the muscle to sag resulting in a little "bag" at the top of the cheek or a worsening of a preexisiting malar bag or festoon. It does not take a whole lot of BOTOX to create this effect. The effect is avoided by carefully controlling how the BOTOX is placed.