Puffy Under Eyes After Botox?

There are several possible reasons for this: 1) Swelling from injection fluid/volume: I don't believe this is your problem because it should be resolved by two weeks after your injection. 2) Lymphedema: This is a more likely possibility. When your muscles move, they pump fluid out of the area. For example when you stand still fluid can "pool" in your ankles and you need to walk to get the muscle pump working to move the fluid out of your legs. This sometimes happens around they... more

Thanks for your question - There are several excellent answers posted below - I'd like to explain in a bit more detail what is likely happening in your case. It is unlikely that the swelling is due to the volume of the fluid or edema injected two weeks after treatment. It is much more likely that there has been a moderate amount of paralysis to your orbicularis oris muscle. This muscle is circular and sits on top of your bony orbit. Paralyzing the muscle can cause increased promience of... more

The other doctors have given you superb detailed answers on what could have possibly caused your problem. The truth of the matter is, Botox injections around the eye area can be extremely tricky. Sometimes the result is great, and sometimes the cosmetic outcome is less than desirable despite adequate muscle relaxation. Looking at your picture, I don't see much of a lower lid fat bulge, and therefore, I don't think it is what is responsible for your problem. I would tend to agree with... more

Injection of Botox in your crow's feet 2 weeks ago is unlikely causing you the problem directly.  Many patients have malar edema that may be more noticeable when the orbicularis along the lateral rim is deactivated by the Botox.  Check with your doctor.

Since you had the BOTOX placed laterally and not beneath the orbit, I would assume that the Botox must have "leaked" to that area. Perhaps, the orbicularis oculi muscle, which surrounds the eye, in your case may be weak in that area allowing the Botox to "leak". Dr. Shafer above probably provides the best explanation: the Botox-weakened OO muscle has allowed the infra-orbital contents to bulge out. Because you are writing this two weeks later, it is unlikely that the... more

Occasionally, the fluid injected along with the the Botox accumulates in the tissues of the lower eyelid and may take 2-3 weeks to resolve fully. Gentle manual massage would be helpful in this case. Alternatively, the problem may be that of loose muscles around the eyes. The good news is the effects of Botox do not last forever. Unfortunately, it will take a few weeks for the appearance to improve and up to 3-4 months for it to resolve fully.

There are many possibilities for the cause, but only one really answer for the problem (time). If it is due to Botox, the good thing is that Botox always goes away. However, it will take 4 to 6 months for the Botox to wear off. If it occurred immediately after the injections, then it is likely due to swelling or hematoma which will resolve over a few days to a few weeks, respectively. If it did not occur for 3 to 7 days after the injections, then you may have to wait several months for... more

Having swelling following Botox injection could be either from swelling and bruising due to a small blood vessel bleed or it could be due to orbicularis muscle relaxation (less likely). I would use arnica, massage, and ice to help with the swelling. It should go away even if it takes weeks. Best of luck!