How Effective is Botox for Under Eye Wrinkles?

Hi, there. I'm a 27 year old woman who has unsightly under eye wrinkles. I take pretty good care if my skin.

However, there seems to be nothing I can do to get rid of the creases under my eyes. My makeup settles in them, they are really aging me.

Will Botox help with this and if not what will? Really appreciate any help with this. Thanks

Doctor Answers 43

Don't let anyone talk you into eyelid surgery

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Dear Leanne

Botox can be used to weaken the lower eyelid orbiclularis that is responsible for making the lower eyelid wrinkles. The problem is that this same bit of muscle also helps hold the lower eyelid up against the eye. Weakening this muscle may smooth the eyelid but the price is usually mild slumping of the lower eyelid margin. This is not a good trade off. Filling the lower eyelid is a good alternative. The product to use is Restylane. An additional option is an appropriate chemical peel to firm the lower eyelid skin.

Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 26 reviews

Botox works only 50% of the time for under eye creases

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Botox or Dysport only works 50% of the time for under eye creases but when it does it is so nice. Expect it to last 3-4 months at a cost of $300 roughly. 

David Hansen, MD
Beverly Hills Dermatologic Surgeon
4.7 out of 5 stars 46 reviews

Consider CO2 laser for under-eye laxity

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For crepiness under the eye, start with a good eye cream and sun protection (sunglasses).  Botox, which only acts on underlying muscles, will not help the loose skin.  I would recommend a chemical peel or CO2 laser for skin tightening.  In more severe cases, blepharoplasty may be a better option.

Under Eye Alternatives More Effective

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Crows feet is a common area where Botox is injected. Lines directly beneath the lower eyelid are addressed in a different fashion because Botox injected here can decrease the tone of the lower eyelid which can result in an untoward shape of the eyelid. Better alternatives you can consider would be some of the new fillers such as Volbella or Belotero which can be injected more superficially. Other options include laser and chemical peels. The type of treatment will be based on the depth of the wrinkles, their exact location along position and tone of the lower eyelid. It is best you consult with someone experienced in treating similar problems.

Robert W. Sheffield, MD
Santa Barbara Plastic Surgeon
4.9 out of 5 stars 21 reviews

Under eye wrinkles botox vs. LASER

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So it depends which lines you are talking about. Those dynamic lines when you smile are from the orbicularis muscle contracting which is a round sphincter type muscle. The wrinkles are then perpendicular to that contraction. This can be improved with botox. I use only a few units under the lid in patients.

The really fine lines that people get under the eyes of the lower lid are really best treated with resurfacing techniques such as chemical peels or lasers. In my hands I get better results with the laser. If you add volume with either fat or fillers this puts the cherry on top to treat this issue. The reason is this is caused by skin aging (loss of elasticity) and volume loss (bone absorption and fat loss). So to best treat we need the combination.

Hope this helps.

Best of luck.


Benjamin Caughlin, MD
Chicago Facial Plastic Surgeon
5.0 out of 5 stars 13 reviews

Botox under eye

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Thank you for your question and for sharing your photo. Botox may help to soften the wrinkles under the eyes. It does require a very small amount and it will help to soften the lines. It will not necessarily reduce all the wrinkles like you might see in the forehead or crows feet region. You will notice a soft relaxation of the dynamic lines under the eyes, and you may notice a slight opening of the eyes. I would start with 1-2 units under the eyes on each side. If you like the effects, then it is very easy to incorporate this into your future treatments. I would recommend visiting with a board certified plastic surgeon or dermatologist in your area to address your concern as it is an advanced area to treat.

Botox for the lower lid

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there is a reason why Botox has not been approved by the FDA for the lower eyelid wrinkles. It cab be a very difficult area to get a good result and the potential negative effects can be visually bad and take a long time to subside. Remember Botox works by weakening muscle and if you weaken the muscles of the lower lid, you might lessen the wrinkles, but you also might get so much weakening that the lower lid lags down, showing the white of your eye and allowing your cornea to get too dry. It might take weeks to months for the negative effect to wear off. I do not inject Botox into the eyelids for those many reasons.

Julio Garcia, MD
Las Vegas Plastic Surgeon
4.8 out of 5 stars 27 reviews

Botox and Eyes

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The simple answer is: Yes!

The key is to distinguish between wrinkles as a result of movement (smiling for instance) vs at rest. Botox and Dysport help with wrinkles as a result of movement; when used correctly they can widen the eye, relax the wrinkles and give a well-rested look. Fillers can be added to correct any hollowing of the area for a better result.

The key is to be examined by an expert and have the right doses of the right material chosen and injected correctly.

Tanya Kormeili, MD
Los Angeles Dermatologist

How Effective is Botox for Under Eye Wrinkles?

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Your lower eyelid wrinkle will likely soften with a very small (1-2U) amount of Botox applied to the inferior aspect of the orbicularis oculi muscle. However, it is unlikely to completely be effaced and there is a risk of the lower lid margin drooping (slight) leaving exposed sclera (white) visible beneath the iris. Since is it temporary (3 - 4months), it is a reasonable first step in treating this area and if you are satisfied with the results, an excellent choice! Alternatives and/or additional therapies to consider other than neuromodulators include application of under eye topical creams, injection of facial filler, chemical peels, and/or laser therapy to improve the fine lines of the lower eyelid. Given your young age, I would pursue non-invasive therapy first before resorting to surgical intervention (blepharoplasty).

Thank you for your question.

Botox for under eye wrinkles

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Botox can be used to improve wrinkles of the lower eyelid area, but must be done cautiously and by a skilled injector. This is an advanced technique that has the potential to create problems (such as bruising, worsening of puffiness, and others) if not performed properly.

In the right patient, this can make a very nice improvement. 

Alternatives might include lower eyelid surgery or laser/chemical peel to the lower eyelid area, depending on the particular patient.

All the best,

Matthew Richardson, MD
Frisco Facial Plastic Surgeon
5.0 out of 5 stars 7 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.