Featured Experts
Dr. Samuel Lin, a board-certified plastic surgeon in Boston
Dr. Melanie Palm, a board-certified dermatologist in San Diego
A new day, a new way of injecting neurotoxins—that’s what it can feel like with a single scroll of your For You page on TikTok. And while some injectable trends are suspect at best, the whimsically named “jelly roll” Botox is the rare one with staying power.
In fact, the concept of injecting the under-eye muscles is decades old and, importantly, one that’s a little more finicky than your average forehead injection. (For the record: in this story, Botox refers to any botulinum toxin, be it Botox, Xeomin, Dysport, or Jeuveau.) With that, here’s what you need to know about jelly roll Botox.
What is jelly roll Botox?
Jelly roll Botox is an injection technique in which a neuromodulator is injected into the muscle under the eye, which can fold up when you smile and create the namesake “jelly roll.” Relaxing the muscle shrinks the jelly roll—meaning the eye size stays open wider when smiling, says Dr. Samuel Lin, a board-certified plastic surgeon in Boston.
And while it seems buzzy, that’s only because of the name. Otherwise, it’s not at all a new technique. “I’ve been doing this for the past decade or longer,” says Dr. Melanie Palm, a board-certified dermatologist in San Diego.
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In fact, it goes all the way back to the emergence of neuromodulators for medical purposes. “Originally, in the 1980s, it was used to treat patients with overactive under-eye muscle involuntary contractions, for a condition known as blepharospasm,” says Dr. Lin. However, it began to be used for cosmetic purposes in the early 2000s, he says, targeting the “jelly roll.”
How jelly roll Botox works
The goal of any botulinum toxin injection—for aesthetic purposes in the face, at least—is to relax an overactive muscle, says Dr. Palm. “In the case of a jelly roll, we’re trying to relax a muscle called the orbicularis oculi muscle,” she says. “In some patients, this muscle is genetically overdeveloped or contracts in an exaggerated manner at the lower eyelash line.”
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Using a small amount of botulinum toxin can relax this muscle, although it’s important to keep in mind that there are multiple muscles involved in smiling—and they can’t all be treated with injectables. Being conservative with the amount is key, since overdoing it—meaning the muscle relaxes too much—can actually make existing puffiness worse. “If treated with too many units of botulinum toxin, this muscle—which normally acts as a sphincter, to help enhance lymphatic flow around the eyelid and cheek—can be over-relaxed, which can result in swelling,” says Dr. Palm.
As a result, it’s important to adjust your expectations accordingly, both in terms of the size of the jelly roll as well as other concerns. For instance, despite what people might claim on social media, “it cannot improve dark circles or puffiness,” she says.
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Who’s a good candidate for jelly roll Botox?
Your provider should assess your entire periorbital area before doing a jelly roll treatment, since, like we mentioned, not everyone needs it. If your concern is actually eye bags from lack of sleep, the jelly roll procedure won’t do much to help, says Dr. Lin, who notes that other procedures might be more effective.
If you’ve had surgery around your eye or eyelid, you could end up with a lag on your lower eyelid. “If you’re are treated in this region, it may cause a functional or aesthetically unpleasing lag on the lower eyelid margin—and can potentially cause dry eye,” she says.
What to be aware of
If the idea of injectables around the eyes makes you think of filler, you’re not alone. And while jelly roll Botox can indeed be paired with filler, this is helpful only in certain cases. (For example, you might also require volume to fill in hollows around the eyes, which would require a filler, says Dr. Palm.) If you do need to combine the two, expect your facial filler to come first, to minimize the risk of the botulinum toxin being unintentionally affected.
Also, keep in mind that doing any cosmetic procedure close to the eye can come with unique risks; the potential complications include asymmetry, drooping, and even difficulty closing your eyes, according to Dr. Lin. “Also, some patients are unhappy with the possible artificial appearance of the area between the injected facial muscle and the cheek,” he says. And if you get too much of the neurotoxin injected, there’s also the risk of excessive scleral show, in which too much of the whites of the eyes are visible.
Finally, even if and when the technique is done well, you might have to return more frequently to maintain your results. That’s because of the lower amount of toxin injected, which just won’t last as long as “treatment of the frown lines, the forehead, or even the crow’s-feet,” says Dr. Palm. She estimates that it lasts only between one and three months with the typical dosing, which might be worth factoring in if you’re on the fence about it.
Ultimately, if your jelly rolls never bothered you before, then this might be one procedure to skip. But if they’ve bothered you in the past, know that there is something—however temporary—you can do about them.
