Botox causes under eye hollows causing my smile to look weird. How do I prevent this from happening again? (Photo)

This under eye hollow can happen when injecting the crow’s feet with Botox because when you paralyze the muscles around the eye, the orbicularis oculi, you lose some of the skin pulling effect of this flexed muscle. You might try going with a lower dosage on your next treatment to see if that alleviates the puffiness underneath the eyes. While you may still see some light crow’s feet, the look overall may be more desirable. In addition, adding some volume to the cheeks and temple with dermal filler can mask this hollowing. I recommend you visit with a board-certified cosmetic dermatologist who is also an expert in Botox. An in-person consultation should help you determine the best way to approach your treatments in the future.

Alterations in how wrinkles form can be pretty common after botox administration as are paralyzing portions of the muscle around the eye.  The orbicularis muscle (which is what forms crows feet) is a muscle that wraps all the way around the eye in a big circle.  We inject just a small portion of that muscle to help with crow's feet but this can cause some alterations with wrinkles below the crow's feet.
Based on your photos, it may be that you need LESS treatment of the crow's feet.  Crow's feet are actually very natural as they are present in us from a very young age and really help convey emotion.  I would consider treating your crow's feet less to get you a reduction in the deeper wrinkles while also maintaining a normal aesthetic.
Good luck!

This is not uncommon.  In the quest to reduce the crow's feet wrinkles, you've lost the muscular lift you needed to pull up the lower eyelid skin from the side.  The result is that hollow under eye or basset hound look you describe.The good news is that there is an answer.  Add volume to the temples and lateral upper cheek.  In doing so, you will provide support for the skin.  That means smoothing it out with tox (botox, xeomin or dysport) wont leave your skin hanging.  In the meantime, let the tox for the crows feet wear off.  Once you have more volume there, you can choose to increase it again, or you may find that the lines are less noticeable despite lighter relaxation of the muscles.  And a few soft crinkles with a smile on a well balanced face look not only more natural but authentic.  (But that is a personal aesthetic)I hope this helps answer your question. Best of luck.

Hi Cicci,
When we treat crows feet and wrinkles of your lower eyelid, we are injecting muscle called Orbicularis Oculi.
This muscle has dual action. It assists you with opening and closing of the eye and also helps to eliminate the fluid we accumulate in the lower eyelid area, by stimulating lymphatic drainage in the lower eyelid. Over the years some of us will develop wrinkles in the lower eyelid areas with repetitive action of this muscle. We refer to these wrinkles as seen on your pre-treatment photos as "jelly roll".
When treating crows feet with the Botox, if you have a higher dose, your wrinkles are likely going to disappear as muscle movements are temporarily diminished. At the same time with muscle not moving a lot in the lower eyelids, your lymphatic drainage is reduced, and you may notice some fluid retention there, causing puffiness under your eyes and emphasising the remaining wrinkles, as we can see on your second photo.
This will gradually improve as the effects of Botox wear off. In the future, you may like to ask your doctor not to inject too many units in the lower eyelid and tear trough area to avoid this problem.
Your wrinkles will still appear softer but without risk of puffiness under the eyes.
I hope this advice is of help to you.
Best Wishes from Melbourne, Australia.