Dysport caused bags under eyes. How long will it be like this? (Photo)

Question

I got 60 units of Dysport in my 11's and a tiny bit in my forehead along with 1cc under each eye. Between my eyebrows looks great and I've had botox before. I have never had it done under my eye and it looks awful. It caused bags under my eyes causing dark circles. Should I do anything to help it look better before it wears off or just wait? Since I had so little done under each eye how long do you think it will last? I'm worried to ever get it there again after this bad job.

Kenneth D. Steinsapir, MD · Answer

I personally advocate stopping crows feet treatment at the lateral raphe.  That is a line of fusion between the upper eyelid and the lower eyelid orbicularis oculi muscle.  If you drew a line straight out form the outer corners of the eyelids, that would approximately locate the lateral raphe.  The orbicularis oculi below this does contribute to crows feet lines.  However, this muscle also "hold the cheek together."  Knocking out this muscle weakens the muscle over this part of the cheek and that causes the bag.  Unfortunately, this muscle is very efficiently treated by small amounts of botulinum toxin.  As a result, it can take months for this effect to wear off.  Don't chase this with other services.  It will eventually resolve.

Jason Emer, MD · Answer

I frequently see this with over treamtent of the lateral orbicularis muscle.  There are a few options at this point, until the neuromodulation wears off : 1) fractional nonablative (fraxel, clear and brilliant); 2) fractional radiofrequency treatments (sublative or viva) ; 3) venus legacy or theramge under the eyes.  All of these help dramatically, best in combination.  Find someone who is an expert in facial rejuvenation and lasers to treat you.  Best, Dr. Emer.

Monika Soni, MD · Answer

Thank you for your question. This is very rare and is often due to poor injection placement. This is a rare side effect of Dysport. Dysport can cause vision changes when it spreads to the muscles that control the movement of the eye. Unfortunately, there is no way to reverse Dysport and will take time to resolve. I recommend following up with your ophthalmologist. Best of Luck!

Michael H. Gold, MD · Answer

Thanks for your question and thanks for including the photos as well as they help very much. Someone chased the lines and that is why you ended up with the concerns you are showing now.  I agree with the others that in time, these will get better as the Dysport effect goes away.  In the meantime, there are several options that you can do which will help right now – these include the fractional lasers – non-ablative fractional lasers and ablative fractional lasers as well as the fractional RF devices and the RF skin tightening devices.  Consult with a board certified dermatologist or plastic surgeon to learn all of your treatment options.

Joshua L. Fox, MD · Answer

I agree
with my colleagues here. Sometimes trying to chase those lower lines around the
eye results in unusual or abnormal smiles. I would wait for the result to wear off.

F. Victor Rueckl, MD (in memoriam) · Answer

I very much agree with Dr. Steinsapir's answer to your question. I find often that injectors overinject areas that we actually need for muscle function. And though it will "stop" a tiny line forming it creates other issues with nearby muscle function and can make things look worse. This is often the case with injections around the mouth too. Because you only had a single unit injected under each eye, the effect may not last the entire 3-4 months' time. But basically, in the future, just don't treat these tiny lines. They aren't worth the risk for most patients. "This answer has been solicited without seeing this patient and
cannot be held as true medical advice, but only opinion. Seek in-person
treatment with a trained medical professional for appropriate care."

Dysport caused bags under eyes. How long will it be like this? (Photo)

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