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Can Botox Be Injected Under the Eye?

asked 3 years ago by Sueanddad in denver, CO
Latest answer by Kris M. Reddy, MD, FACS
Question viewed 80,874 times
Tags: under eyes, effectiveness

I have crinkles under my eye.  My dermatologist and others refuse to put Botox under the eye.  The crinkles come when I smile, so I realize that it is my cheeks that are pushing into the eye area and cause the crinkles to form. One expert recommended fraxel which did nothing for the crinkles. I have heard that some doctors will put botox under the eye, is this possible?

29 answers to Can Botox Be Injected Under the Eye?

+1

Options for under eye wrinkles

Although Botox injections may be helpful in softening lines/wrinkles in this area, it usually should be reserved for those that are younger and without skin laxity. Performing a "snap test" to the skin in this area is usually a good, simple way to determine whether or not injecting in this area would be an option. The snap test involves a quick pull down on the skin under the eye with a quick release. If the skin bounces back and resumes its place, then injecting Botox in this area... more
Harold J. Kaplan, MD

Los Angeles Facial Plastic Surgeon

www.celibre.com

+4

Botox can be injected on the under eyes

Thank you for your question. It is possible to put Botox underneath the eye to help with those lines as well as the small bags that form under the eyes. A small bleb of botox (1-2 units) is placed in the area where the bags are. This should really only be done when the crow's feet are being treated wtih Botox at the same time, otherwise the effect will be minimal. Keep in mind, that, the cheek muscles are strong and if you have bulbous or bigger cheeks, lines will continue to form underneath... more
Don Mehrabi, MD

Beverly Hills Dermatologist
+3

Not everyone will benefit from Botox under the eyes

Botox works well for the thicker band of muscle that some people have, but if the lines form when you make a big smile, then I doubt you will see improvement from undereyelid placement of Botox. This is because you would have to have the Botox placed over the cheek bone, and this would possibly interfere with smiling, eating and speaking. You might look different from side to side, your corner of the lip lower on one side, etc.
Ronald Shelton, MD

Manhattan Dermatologist
+2

A tiny amount of Botox under the eye COULD be helpful, but is high risk.

Your doctor may be correct in your situation, to avoid the Botox directly under the eye. It is very individual, and depends what the purpose of it is exactly. Remember that Botox does NOT smooth wrinkles. It only weakens underlying muscles. This may have the effect of smoothing a wrinkle, or it may have the effect of weakening the muscles that are important for blinking and closing your eyes safely. In addition, too much Botox around the lower lid can actually cause sagging and bagging.... more
Jessica J. Krant, MD, MPH

Manhattan Dermatologic Surgeon

www.ArtofDermatology.com

+2

Botox under eyes

Sometimes botox is used in the lower eyelid for "orbicularis hypertrophy". This is when the muscles around the lower eyelid is strong and forms a ridge under the eyelid. For wrinkles that are caused when you smile, what is happening is that your cheeks are raising and "crinkling" the skin under the eyelid. Botox would only work by paralyzing the cheeks, thus not allowing your to raise the cheeks. An option that I think is not too good. This is a more difficult problem... more
Chris Thiagarajah, MD

Washington DC Oculoplastic Surgeon
+2

Yes, Botox injections under eyes is possible

Sue, You can indeed put small amounts of Botox under the eyelid to smooth the lower lid.  Seek out a plastic surgeon or dermatologist who is skilled in this application. Good luck!
Kenneth R. Francis, MD

Manhattan Plastic Surgeon
+2

Botox can be injected under the eyes

I do Botox injections under the eyes fairly routinely. The thing is that it must be used cautiously, and in small amounts only so that the lower eyelid function is not impaired.
Scott E. Kasden, MD

Dallas Plastic Surgeon
+2

Yes, but VERY cautiously.

To Sueanddad, Hi!  I have injected tiny amounts (2-3 units) of Botox into the lower eyelids with improvement.  But it is easy to get a deformity here.  So if your doctors are not comfortable trying this, they have good reason. Erbium laser resurfacing of the lower lids can help.
George J. Beraka, MD

Manhattan Plastic Surgeon
+2

Under eye-great place for very small quantities of BOTOX

Generally, when a doctor tells you that something can't be done, it means that it has not been successful in their hands. My father liked to say: "If the butcher tells you the meat's bad, you should listen." The key with under eye Botox treatment is finding a clinician who is comfortable and experienced with this type of treatment. Don't make your doctor do a treatment they have told you they don't do well. The lower eyelid orbicularis muscle makes those crinkling lines. This... more
Kenneth D. Steinsapir, MD

Los Angeles Oculoplastic Surgeon
+2

Botox in small amounts okay for undereye wrinkles

Sure, Botox can be injected in small amounts into the wrinkles under the eye that occur with animation, or when you smile. Many people have these wrinkles that occur when the muscle called the orbicularis oculi contracts with laughing or smiling, and when they become noticeable or aesthetically bothersome, tiny amounts of Botox can be injected into the parts of the muscle of the lower lid that is hyperkinetic (or moving a lot to cause the wrinkles). I would recommend speaking to a... more
Jennifer Walden, MD

Austin Plastic Surgeon
+1

Botox under the eye

While it is possible to put Botox under the eye, it is important to choose the right candidate. Therefore, it may be appropriate that these physicians have refused to do the treatment for you.
Kris M. Reddy, MD, FACS

West Palm Beach Plastic Surgeon

www.drkrisreddy.com

+1

Botox Under the Eye works well for some patients

Botox underneath the eye is an off label use of Botox, I use it often for patients who get the under eye "scrunch." Their muscle is active there and 1-2 units of Botox can help smooth it out. The low units don't last long, but they are effective. I tell my patients it might be harder to squint and to make sure to wear sunglasses. My patients are happy with this treatment.
Rebecca Baxt, MD

New York Dermatologist
+1

Can Botox Be Injected Under the Eye?

Botox should not be injected under the eye, because it will affect the muscle which has to remain functioning in order to close the eyes and make blinking possible.
Kris Conrad, MD

Toronto Facial Plastic Surgeon
+1

Botox can be injected under the eyes

Yes, Botox works great under the eyes. Delicate injection is important. There are new injection methods, called lateral injections, that enable a qualified physician to smooth out most of the lines that are noticed with smiling or squinting, including the lines near the nose.
Christine Glavey, MD

Atlanta Dermatologic Surgeon
+1

Botox around eyes

Botox can be injected and is effective for fine lines around the eyes (crows feet). The amount of botox you will need depends on the depth and length of these lines. See your dermatologist for a consultation.
Gary Goldenberg, MD

New York Dermatologist
+1

Botox under the eyes

Botox does not eliminate wrinkles under the eyes. Botox works well for blepharospasm, uncontrolled "tics" that can occur under the eyes, but not wrinkles. Eyelid surgery, chemical peels or laser treatments work well for the lines under the eyes.
David Finkle, MD

Omaha Plastic Surgeon
+1

Lower eye area

While it is difficult to give the right answer to your problem without seeing your pictures or examining you, it sounds like Botox is least likely to help you. resurfacing with lasers or peels could be helpful, as may be a blepharoplasty. Sincerely, Martin Jugenburg, MD
Martin Jugenburg, MD

Toronto Plastic Surgeon

www.torontosurgery.ca

+1

Botox can be placed under the eye

It is only useful under the eye if there is an unwanted bulging of the lower eyelid when one squints or smiles (with the eyes).  It has to be done carefully because it can subtly change the shape of the eyes as it relaxes the lower eyelid.  For crinkling and laxity of the lower eyelid skin, resurfacing laser with erbium or fractional CO2 is the best. 
Felix Kuo, MD

Long Island Dermatologist
+1

Can Botox Be Injected Under the Eye?

Yes, as long as a physician examines your eyelids and deems that paralysis of some of the muscles in that area will not cause a problem .  I personally inject in that area for a variety of reasons.  I am not sure if your problem is treatable with the Botox, that would depend on your examination.
Sam Goldberger, MD

Beverly Hills Oculoplastic Surgeon
+1

Botox Under the Eyes for Wrinkles

Small amounts of Botox typically 1-3 units right under the midline of the lower lid helps certain patients with the wrinkles under the eyes.  If the patient has large fat pads under the eyes, they are generally not good canidates since the muscle under the eyes holds the fat pads in.  If you relax that muscle, you will get rid of the wrinkles but the patients tend to look more tired since their fat pad then bulge out more.  Botox injections under the eyes also last a short... more
Grace Liu, MD

Newport Beach Dermatologic Surgeon
+1

Botox under the eyes

If there is a fold of skin under the eyes when you smile, one or two units of botox injected into that fold can relax it very nicely.  The needle has to be held parallel to the skin and only a small amount injected. Emily M. Altman, MD
Emily Altman, MD

Short Hills Dermatologic Surgeon
+1

Botox under the eyes.

I also rarely use Botox under the eyes. As you explain in your quesion, the crinkles come when your cheeks push up (when you are smiling usually). The only way to stop this movement would be to stop you from smiling (not very practical). Resurfacing the area might help the crinkles, and if Fraxel did not work, then fractional CO2 is much more effective at treating wrinkles and we get especially good results around and under the eyes. The only time I use Botox... more
Todd Minars, MD

Miami Dermatologist
+1

Botox can be used under the eye for wrinkles

I have successfully placed small amounts of Botox under the eye to soften lines there.  It also can help diminish muscle folds there and I routinely put "Baby Botox" in the lower lid at the same time I treat crows feet.
Darrick E. Antell, MD

Manhattan Plastic Surgeon
+1

Botox under the eye has some benefit in select patients

Botox is probably not appropriate under the eye for you but in patients whose eyes get smaller when they smile there is a benefit. First I check that the lower eyelid skin "snaps back" when it is pulled. One or two units of Botox in the lower lid will keep the eyes wider when the patient smiles.
Susan Van Dyke, MD

Paradise Valley Dermatologist
+1

Botox treatment around the eyes

Botox works by weakening the facial muscles of expression. When a specific muscle causes a wrinkle than treating that muscle will make that wrinkle dissipate.  Your doctor should be able to tell if the smiling creases in your lower lids are caused by orbicularis muscle or by larger muscles of the face.  Depending on your anatomy treating lower lids with Botox can work quite nicely.  As with any procedure, your doctor's experience, talent and judgment is quite important... more
Boris M. Ackerman, MD

Newport Beach Plastic Surgeon
+1

Botox can be injected on wrinkles under the eye

Sueanddad, I use Botox for fine wrinkles under the eyes, but you have to be careful - too much can cause problems. Too much Botox can cause the obicularis muscle to relax too much. This in turn can cause bulging and bags if you have an attenuated orbital septum (the layer that holds the fat under the eye in place). I'm not sure which Fraxel machine your doctor used, but many patients complained to me that the Fraxel just didn't work. I like to use erbium laser resurfacing to tighten the... more
Daniel Reichner, MD

Newport Beach Plastic Surgeon
+1

Botox under the eye beneficial for qualified individuals

Botox can be injected under the eye, to decrease activity of the infraorbital orbicularis muscle. Such treatment can be useful in younger individuals. Botox injections in this area can cause problems for older individuals, those who have undergone surgery beneath the eye, those with a large amount of redundant skin beneath the eye and individuals with a history of dry eyes (can make it worse). For individuals who are good candidates for injection under the eyes, I usually limit the dose to... more
Bryan K. Chen, MD

San Diego Dermatologist
+1

Botox under the eye for specific conditions only

There are some very specific cases where botox under the eye can be beneficial, but you should trust your doctor's advice here. When the problem is hyperactivity of the muscle directly under the eyelashes, very low dose botox can be helpful. Usually it is used for the muscles lateral to the eye, the "crow's feet". Wrinkles in the under eye area are more likely to be caused by the skin being pushed up into the area with smiling. Since the cheek skin is thicker than the eyelid skin,... more
Richard Baxter, MD

Seattle Plastic Surgeon
+1

Botox can be injected under the eyes

Using Botox under and around the eyes can be very effective in helping to smooth out the wrinkles in this area. However, you should only have this procedure done with a physician who is very comfortable and familiar with the technique. Though it is possible that the crinkles are from your cheeks pushing up, it is likely that it also has to do with the orbicularis oculi - the muscle around your eye. It is this muscle that Botox can be injected into to help your wrinkles.
Jeffrey Ellis, MD

Long Island Dermatologic Surgeon

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