Can You Have Botox Directly Underneath Your Eye?

Botulinum Toxin (Dysport or Botox) may relieve some of the wrinkles in the lower lid but there are consequences to weakening the lower eyelid muscle including worsening of bags or slceral show or differences on movement of eyelid and cheek skin

I have been routinely injecting Botox for treating under eye (lower lid) fine wrinkles, crepeyness, and rolled bulges (resulting from a slight hypertrophy or thickening of the muscles in the region)  for nearly fifteen years. More recently, I have also used Dysport successfully for these same purposes.

Treatment of the lower lid region with either of these materials usually requires only one to two microdroplets placed superficially within the skin on each side. In addition to diminution of fine lines and of the crepe paper appearance, treatment in this fashion frequently gives rise to a slight widening  or opening up of the eyes, which is also quite pleasing and which tends to make the eyes look less tired.

Botox and Dysport are not intended to treat bags under the eyes due skin laxity or volume shifts leading to hollowness and darkness in that area. They should also be avoided in individuals with significant redundancy. Each of these problems conditions may appear more pronounced following treatment and may instead be managed via a variety of other nonsurgical rejuvenation approaches, such as volume restoration, superficial chemical peels and prescription home use products. 

I often inject botox under the eye as well when injecting the crow's feet since it helps with those annoying lower eyelid creases half of the time.  Don't expect it to work all the time, but when it does, it is really nice.  Cost for crow's feet area is $300.

Injections of skin immediately under the eyelid margin of the lower eyelid, can be done with Botox for both skin wrinkles and hypertrophic muscle (bulging muscle bands), but if someone has a history of fluid bags in this location, even if not present at the time of consultation, then Botox should not be done because without the sphincter function of the muscle, the fluid won't drain away and the eyelids may become very swollen.  Injections of the midpupillary line, right above the eyebrow, risk affecting the levator which helps hold the eyelid up. Upper eyelid droop, even if only 2 mm., is very significant. Special eyedrops, Iopidine, may help elevate the upper eyelid while waiting for the Botox to wear offf.

Yes, you can have BOTOX injected in the lower eyelid underneath your eye, but only in small units. And, I would suggest looking for an oculofacial plastic surgeon specializing in injectables as these specialists are the most knowledgeable about the delicate structures around the eyes.

2-3 units of Botox smooths undereye wrinkles and that rolled pocket that forms with smiling. The patient must first be given a snap test, and should never be done on patients with lax skin under the eyes. It makes the eyes look less almond shaped and more round, so be prepared for this. I do not recommend it in Caucasian patients over 35 years old as it can cause puffiness.

Botox can be used for some wrinkles directly below the eyes.  It can improve wrinkles caused by thick or overactive eye muscles.  It can also open the eye to some degree.  If you have undereye bags caused by fat or fluid rather than an overactive muscle, Botox under the eye can actually make the bags look worse.

If you have a strong lower lid which the doctor can tell with a "snap test", then 1-1.5 units per eye is good for those undereye wrinkles.  It's not going to eliminate them, but will make them better.  If your lower eyelid is loose, then botox will cause drooping of the lower lid (ectropian) and shouldn't be done.