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Botox for Under Eye Wrinkles?

I have fine lines under my eyes and droopiness between my eyelid and my eyebrow. I know Botox will help with the upper eye part but will it also help with the wrinkles under my eyes? THAT'S the part that bothers me more than the upper eye.

Doctor Answers (14)

Caution: Botulinum Toxin (Dysport or Botox) into lower eyelid

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Botulinum Toxin (Dysport or Botox) may relieve some of the wrinkles in the lower lid but there are consequences to weakening the lower eyelid muscle including worsening of bags or slceral show or differences on movement of eyelid and cheek skin.


Chicago Plastic Surgeon
5.0 out of 5 stars 44 reviews

BOTOX can be helpful for the wrinkles caused by muscle movement

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BOTOX can be helpful for the wrinkles caused by muscle movement, but not for fine lines in the skin under the eyes.

Joseph A. Eviatar, MD, FACS
New York Oculoplastic Surgeon
5.0 out of 5 stars 22 reviews

Botox can help for undereye wrinkles

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Botox and Dysport are both injectable proteins that can relax the targeted muscles. Botox into the strong muscles that pull down the brow can result in a moderate, but pleasing, non-surgical elevation of the brows. Botox or Dysport can also be used at the side of the eyes (crows feet) to relax these lines. Botox under the eyes can be somewhat more problematic and hence specialized to certain patients (and injected by experience doctors) Very fine line under the eyes from a very dynamic eye closing muscle (the orbicularis occuli) can, in selected cased result in some mild to moderate fine line improvement, however, not all lower lid eye wrinkle patients are candidates.

The best responders to lower lid botox have a "bulge" of the closing muscle on squinting (also called the "tootsie roll"). Fine line lower lid wrinkles can be improved with Fractional ablative (Fractional CO2, Erbium and Fractional RF systems) and non-ablative (Fraxel, Affirm, Ematrix to name a few) or even chemical peel in conjunction with botox and even soft tissue fillers, like juvederm and restylane. . There are some risks to botox used under the eye and most physicians will be wary of using botox on the lower lids of patients with dry eye symptoms, previous blepharoplasty, lower lid bags, lymph pads of the lower lid and lower lid laxity. Of course, always seek a formal in-office consultation with a specialist before embarking on a course of action from any online advice.

R. Stephen Mulholland, MD
Toronto Plastic Surgeon
4.5 out of 5 stars 7 reviews

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Botox can be safely used to improve the contour of the lower eyelids

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Botox can be safely used to improve the contour of the lower eyelids. This is an advanced use of Botox and is best performed by a doctor highly trained in injecting this material. For more information see the link below.

William P. Coleman III, MD
Metairie Dermatologic Surgeon
3.5 out of 5 stars 2 reviews

Botox can treat crow's feet that extend slightly below the eyes

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Botox can be helpful for fine lines under the eyes to a certain extent. The lines around the eyes which sometimes extend slightly below the eye can be treated with Botox treatments to the crow's feet. For lines directly under the eyes, Botox typically can not be safely used.

Thomas Buonassisi, MD
Vancouver Facial Plastic Surgeon
5.0 out of 5 stars 56 reviews

5 Ways to Enhance Botox of Eye Wrinkles

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Botox, being primarily a muscle relaxant, works only for muscle hypertrophy, muscle bands, or movement related wrinkles under the eyes. 

Most people have a combination of lower lid fat pads, thin skin, movement related lines, and some fat bags.  Consequently, therapy, especially using non-surgical options, requires combination approach.

I have found the following options, often in combinations, works best in conjunction with botox:

1.  low dose botox:   in the crow's feet, followed by conservative dosage in the lower lid, lateral to the medial limbus(the inside border of the pupil)

2. resurfacing or skin tightening: with TCA peels or laser resurfacing such as Fraxel, and Thermage for no-down time option

3. dermal thickening:  PRP injection, over several sessions, appear to thicken the dermis and remains the best option for skin immeidately under the eyelash margin

4.  fillers:  hyaluronic acid(shorter acting) or scultra(longer acting) to improve the nasojugal or tear drop area

5.  fat shrinkage:  Using the face tip, when used properly to engage in deep heat, will conservatively shrink the eye bag fat.

George Sun, MD
Los Angeles Facial Plastic Surgeon

Botox for Wrinkles Below the Eyes

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In the right patient, Botox can help with wrinkles below the eyes.  Wrinkles caused by an overactive muscle can be imrpoved with Botox.  However, if wrinkles are caused by loose skin or volume loss, Botox will not help.  In fact, in some patients, Botox under the eyes can make wrinkles and loweer eyelid puffiness look worse.  You should see your Dermatolgist for an in-person evaluation.

Joshua Zeichner, MD
Manhattan Dermatologist
5.0 out of 5 stars 1 review

Botox not the b est for lower eyelid lines

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Trying to minimize lower eyelid wrinkles with botox risks affecting important function of the eyelid and even lip. Make sure you seen an experienced physician and consider laser resurfacing and fillers.

Ronald Shelton, MD
Manhattan Dermatologist
5.0 out of 5 stars 31 reviews

Botox works for fine lines of the lower eyelid but with caution

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I will use Botox in small units to decrease the fine lines of the lower eyelid. Care should be taken since too much Botox may result in decreasing eyelid tone producing a droopy eyelid. There are other techniques to reduce the wrinkles. In my practice, I will incorporate Thermage and Fraxel. When non-invasive procedures fail, recommend surgery to my patients. The surgery is a lower lid blepharoplasty.

Randall Latorre, MD
Tampa Facial Plastic Surgeon

Botox and under eye lines

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Botox will not help the under eye lines. In fact it may lead to weakness of the muscle there and could lead to scleral show.

Steven Wallach, MD
Manhattan Plastic Surgeon
4.5 out of 5 stars 17 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.