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Botox Didn't Work for Eye Wrinkles - Should I Get Fillers?

asked 1 year ago by ksg1648 in australia
Latest answer by Arnold W. Klein, MD
Question viewed 1,644 times
Tags: eyes, female, filler

Hi team thanks to your responses from my past question - i got botox twice now with a leading surgeon under my lash line and also in my temples to try and weaken the muscle which is causing my horrid eye wrinkles when i smile. The lady has now suggested fillers to plump up the skin under my eye which would result in there not being that fold of skin when i smile as it would be nice and plump. Any comments before i go ahead? thanks team!

22 answers to Botox Didn't Work for Eye Wrinkles - Should I Get Fillers?

Am I a good candidate for Under Eye Injections?

Hi KSG. Based on the photo you submitted, we think you are a good candidate for "tear trough" injections, which is the name of the procedure for filling the under eye. We cannot see what the crow's feet (sides of eyes) looked like while smiling so it is possible you received some benefit from the Botox from those injections, but Botox would not help under the eyes. We use Restylane and you can view before and after pictures of tear trough injections at... more

Harold J. Kaplan, MD
Los Angeles Facial Plastic Surgeon

www.celibre.com

Blepharoplasty, not fillers!

Your photos reveal a candidate for a lower eyeld surgical lift. You need surgery, fillers will be useless according to your photos. Get more opinions from 3 ABPS FACS surgeons. You need more evaluation. Good Luck.

George Commons, MD
Palo Alto Plastic Surgeon

Treatment for under-eye wrinkles

This is an excellent case for fillers and Botox. I was the first person to use Botox under the eye for eye widening as well as the first to employ a 32 gauge needle for Restylane in the tear trough. I remember when Michael Kane gave me credit for the latter. First, employ Restylane with a 32 gauge needle to fill in the tear trough. Then place 2 units of Botox under he skin directly below the pupil. You might just shock yourself on the degree of improvement you achieve. more

Arnold W. Klein, MD
Beverly Hills Dermatologic Surgeon

Pinch Blepharoplasty can beat Botox results.

I have used Botox beneath the eye with mixed results. Some people like it, most find it to be an uncomfortable waste of time and money. Pinch blepharoplasty, an abbreviated type of lower eyelid surgery (local only, no anesthesia recovery) is often the answer. It's long lasting (years) and does a lot more than Botox in this area. My website has before and after photos of Pinch Blepharoplasty.

Ritu Chopra, MD
Beverly Hills Plastic Surgeon

Fillers can be a good option for wrinkles in the skin

Yes. Fillers can be a good option for wrinkles in the skin, you just have to make sure you are seeing an oculofacial plastic surgeon who is an injectable specialist. You don’t want to go to a dermatoligest to inject filler around the eyes. You need a specialist as the eye area is very delicate and it’s extremely important to find the right physician for this kind of treatment. see video

Joseph A. Eviatar, MD
Bronx Oculoplastic Surgeon

Eyelid Wrinkles

Based on your photos, you would be a candidate for a lower blepharoplasty woth emphasis of removing excess skin. Seek the advice of an eyelid specialist. Good luck

John Pak, MD, PhD
Chicago Oculoplastic Surgeon

Best Treatment for Lower Lid Crepe` Excess Skin...Fraxel repair and/or Lower Lid Skin Pinch

Gid Day Aussie, You look like you would be an excellent candidate for a skin pinch lower eyelid procedure. If you wish to treat non surgically and less invasively, then go with Fraxel repair treatment. If you want to go holistic, try a little Vegemite spread on the lower lids overnight (just kiddin' about that one). Bee's knees. Good luck and be well. Dr. P

Michael A. Persky, MD
Los Angeles Facial Plastic Surgeon

Botox or filler for lower eyelid lines when smiling

Your condition may not improve and could look different and not pleasing secondary to swelling with fillers in the lower eyelids. Botox can't immobilize the smile muscles which are generating the lower eyelid creases now that the crows feet are treated well. If the smile muscles are treated then you won't move your mouth correctly and your smile and eating and speech will not be good. Fillers are best to correct lines at rest but if they are used to correct the lines that... more

Ronald Shelton, MD
Manhattan Dermatologist

Fillers for Eye Wrinkles

If you're talking about the wrinkles immediately under the lashes of your lower lids, I'd recommend skin excision. If your concerned about the depressions at the lower margin of the lids, fillers would help.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon

Beware! Wrong Diagnosis May Lead to Wrong Treatment

It is almost impossible to make an accurate diagnosis of your problem with out examining you because the picture is one static image and the lower eyelid lines most definitely change with your expression, gaze and eyelid position. That said, I do not believe BOTOX and/or filler is the correct treatment for these lines. Oftentimes, lines such as yours are caused by buldges of muscle in the lower lid. These can occur as a result of extended periods of squinting i.e., from... more

Michelle R. Yagoda, MD
New York Facial Plastic Surgeon

Using a filler to elevate cheeks is often the best way to support the skin of the lower eyelid

Using a filler to elevate cheeks is often the best way to support the skin of the lower eyelid. This is because many patients with eyelid wrinkles because of loss of volume of their cheeks.

Edward Lack, MD
Chicago Dermatologist

Botox for Eyelid Wrinkles

Botox is not used for and does not work for the wrinkles you are trying to great. Botox works by weakening the underlying muscles which softens dynamic (movement) wrinkles in the overlying skin. Your lower lid wrinkles are more of an anatomic issue which would require a lower lid blepharoplasty to treat. Injecting filler under your eyelids - in your case - would not solve the problem either. You do not have a volume deficit which fillers are used to treat. Botox... more

David Shafer, MD
New York Plastic Surgeon

www.ShaferPlasticSurgery.com

Fillers are not for eyelid wrinkles

I believe that fillers should not be used for eyelid wrinkles. The skin is too thin so, even in the best of hands, the filler will usually look bumpy and may even be visible through the skin. A lower lid blepharoplasty is your best bet. And if the wrinkles occur only when you smile, surgery may still not be the answer.

Mitchell Schwartz, MD
South Burlington Dermatologic Surgeon

dorsetstreetdermatology.com

Botox in lower lids

Botox does not help lower lid wrinkles. A lower lid blepharoplasty where only skin is removed is what you need. Fillers will not help those wrinkles either. Fillers will improve the hollowness in your upper lids though.

Peter T. Truong, MD
Fresno Oculoplastic Surgeon

www.facialsurgerydr.com

Options for lower eyelid wrinkles

Although Botox can work very well for the crow's feet area (at the side of the eyes), it is a little more difficult to get a comprehensive result with the wrinkling that can occur underneath the eyes. In my opinion, a filler may not be the optimal treatment for correcting your problem of wrinkling when you smile. It is natural that when you smile, your cheeks will move upward and bunch up the skin under and around your eyes. It would be difficult to place a filler in this region that... more

Haresh Yalamanchili, MD
Houston Facial Plastic Surgeon

Skin under eyes

All the fillers and Botox will not treat the loose lower eyelid skin. WHile those are great things to use for the right indication, a simple skin blepharoplasty will improve the looks of the lower lid.

Steven Wallach, MD
Manhattan Plastic Surgeon

This should be helpful.

Dear KSG One needs to be exceptionally careful with both under eye BOTOX and under eye fillers especially since no one wants a treatment that makes them look worse. The issue with under eye BOTOX (any BoNTA) is that one can weaken the muscle right under the eyelashes that holds the eyelid up. This can cause the eyelid margin to fall or slump-not good. This type of treatment can be done by it is really an advanced technique. FIllers are generally a better... more

Kenneth D. Steinsapir, MD
Los Angeles Oculoplastic Surgeon

Injectable Fillers are not helpful for wrinkled lower eyelid skin.

I read your concern and reviewed your photo. The bunching of skin below your lower lash-line is a difficult problem to fix. I have not had favorable results with Botox, which is similar to your experience. In my view, Injectable Fillers are helpful for lower eyelid grooves that are below a lid-bag. I would not advise getting fillers under the wrinkled skin (orbicularis roll). My hunch is that you will not be pleased by the result. Regards from NJ:

Eric M. Joseph, MD
West Orange Facial Plastic Surgeon

Consider pinch instead of fillers

By your photo, I would consider a pinch procedure to rid you of your wrinkles. If you had a trough under the eye, then fillers are great. If you were not smiling in the photo, you have excess skin in the lower lids. This can easily be treated by simply removing the excess skin using local anesthetic. The resulting scar is virtually invisible. Andrew Campbell, M.D. Board Certified Facial Plastic Surgeon

Andrew Campbell, MD
Milwaukee Facial Plastic Surgeon

www.campbellplastics.com

Fillers under the eyes.

As long as the surgeon does this a little at a time you should do well. If too much is put in you will have a lump.

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon

Fillers under the eyes

In the right surgeons hands, fillers under the eyes can soften the appearance of tear troughs. In the wrong hands, the results can be disastrous. So tread carefully here.

Steven Hacker, MD
West Palm Beach Dermatologic Surgeon

www.palmbeachdermasurgery.com

Lower eyelid wrinkles, what to do?

First, it is difficult to asses the best treatment for you with just a photo and without seeing your enitre face and how it moves. However, from your picture it appears that you are concerned with the lines that appear directly under your eyes when you are smiling. These lines are emphasized by the upward motion of the cheek when it moves toward the lower eyelid. I suspect that when you smile the lines are not as noticeable. I do not think that fillers will help you... more