Botox Under Eye Has Caused Huge Bags and Wrinkles

Botox is excellent for frown lines and crow's feet that appear around the eyes. For wrinkles of the lower eyelids, they may be from over-active muscles called the orbicularis oculi muscles. However, treating under-eye wrinkles with Botox can also make bags bigger. The lower eyelid is made up of skin, muscle, fat then a layer called the orbital septum then fat. If the septum is already weak, the only thing holding back the lower eyelid fat from bulging is the muscle; weaken that muscle and you get puffy eyes or bags.

I am careful to first dissuade then warn each patient I treat with Botox under the eyes. For those with little fat and excellent muscle tone, the results can be very rewarding, but all patients are also cautioned that bags can appear or look worse. Fortunately, Botox does wear off, but it takes a few months.

Without seeing you in person and examining you before and after the treatment it is not fair for any physician to comment on your specific situation. You did not state that the doctor injected below the eyelid, but at the corner of the eyelid. This is a common location for many physicians to inject but we don't know exactly how far from the orbital bone the insertions were.It is possible that you have unique anatomy so that the normal treatment given by many expert physicians who have commented on this panel could have seen a similar result. The photographs appear to demonstrate some protrusion of the lower eyelid fat pads and if you didn't have this before then fortuntately this is pseudoherniation of the fat pads and will resolve over time, a few months. The wrinkling might be from compensatory excessive contraction of the rest of the muscle below the eye that wasn't affected by the Botox.Although there is a possibility that Fraxel Restore or Pelleve may help reduce some of the wrinkling temporarily, there might be excessive swelling if your eyelid muscles are not working normally.

We are curious if you returned to your physician after the suggested waiting time to determine if there was improvement or helpful feedback from her.

Without knowing the details of your treatment, it would appear that the technique/dosing used may be responsible for your negative outcome.  For example, we do not inject below the lower eye muscle because of this concern.

Although it doesn't offer much comfort in the present, time will improve your condition.

Botox is a medication that should be injected in the crow's feet area of the eyes. The lower eyelid should be  avoided as one can weaken the lower eyelid muscles causing difficulty in the eyelids closing. From the pictures that I see, it would be difficult for me to comment as there is a difference in lighting. Generally speaking Botox does not cause bags . A baggy lower eyelid or an eyelid with many lines was probably present before the treatment was initiated.

Botox injected too deeply around the eyes can cause swelling under the eyes since relaxing the muscle pump in this area will cause fluid to accumulate.  Lymphatic drainage techniques offered by some aestheticians below the eyes may help.  Sleeping on a few pillows to elevate your head and cold steeped green tea bags may also help but you will need to wait a few months until the Botox effect wears off.  Next time, fewer units of Botox placed superficially should prevent this swelling.  Please have treatment with a dermatologist or plastic surgeon who is an experienced injector.