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 34

Don't let anyone talk you into eyelid surgery

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.

Los Angeles Oculoplastic Surgeon
4.9 out of 5 stars 23 reviews

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

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
4.8 out of 5 stars 37 reviews

Consider CO2 laser for under-eye laxity

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.

Botox under eye

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 and Eyes

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
5.0 out of 5 stars 6 reviews

Botox for Under Eye Wrinkles

Botox for this area should only be performed by an experienced and expert physician injector. It will improve under eye creases about 50% of the time. Patient selection is key. 

Kris M. Reddy, MD, FACS
West Palm Beach Plastic Surgeon
4.5 out of 5 stars 36 reviews

Botox for lower eyelid wrinkles

Although Botox is only approved to improve the appearance of moderate to severe frown lines between the brows and crow's feet lines,  it can be used to smooth lower eyelid wrinkles.  I would recommend a low dose (2 units per eyelid).  If the orbicularis oculi muscle is weakened with a large dose, it might cause ectropion or drooping of the lower eyelid.

Karen E. Wells, MD
Tampa Plastic Surgeon

How Effective is Botox for Under Eye Wrinkles

Thank you for submitting your question.  Botox can be used conservatively by an experienced injector to relax and smooth some of the lower eyelid creases. Too much may cause laxity of the lower eyelid support.  Consult with a board certified experienced injector. Best Wishes. 

Undereye wrinkles

Botox may not be right for you. You may want to consider laser treatments instead or fillers. Either way, you should seek an in person evaluation with a board certified plastic surgeon or dermatologist to determine what the best course of treatment is

Botox for under eye wrinkles? Yes and No.

By now you are probably aware that botox cosmetic is approved for use around the corners of the eyes, an area referred to as smile lines or crow's feet.  The approved areas for injection are lateral or outside the corner of the eye.

Despite that, we most commonly will inject the Botox more toward the area directly under the eye provided the patient meets certain physical examination characteristics to ensure this is a safe option.  We should be checking the movement of the lower lid to be sure that its strength can tolerate the relaxation of the muscles.

There are so many tools that can be helpful to influence a very youthful lower eyelid:

1.)  Skin tone can be affected by hyperactive muscles and Botox Cosmetic or Dysport can be used in this case.
2.)  General loss of volume can cause excess laxity and increasing wrinkling.  This can be treated with hyaluronic acid fillers or even a patient's own fat for transfer.
3.)  Aging skin that has lost too much elastic property and collagen content will need to undergo resurfacing to stimulate the body's healing processes.  We commonly will use peels (88% phenol), carbon dioxide fractionated, or erbium lasers to achieve this goal depending on a patients skin type.
4.)  At age 27, I would love to recommend the above to address your issues.  Surgery is probably not an option in your case but is remarkably well tolerated producing long-lasting results and so many smiling patients!

I appreciate your willingness to share your photos, but your physician really has to physically examine your eyelids to make any recommendations for you.
Best of luck with your care.  You'll do great.
Dr. Hobgood

Todd Christopher Hobgood, MD
Phoenix Facial Plastic Surgeon
4.9 out of 5 stars 46 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.