Botox for Undereye Bags?

The typical bags under eyelids are caused by swelling of fluid or herniated fat pads so that there would not be an expected improvement with Botox injections.  Some patients do, however, have an enlargement of the muscle tissue of the lower eyelid and this hypertrophic orbicularis oculi muscle may thin down after Botox injections diminish the muscular contraction. This should only be done by a well-experienced Botox physician injector.

Botox is not intended to treat under eye bags.  Botox is a injectable that is used to temporarily treat wrinkles around the eyes, forehead, and glabella.  The best option for bags under the eyes is a procedure called lower Blepharoplasty.  It removes the excess fat under the eyes therefore reducing under eye puffiness.  Consult your board certified plastic surgeon to be evaluated for the best treatment for you. 

Dear lad68,
I like to think of Botox as something that is used for dynamic lines or lines that are obvious when you are moving a particular muscle on the face. On the other hand, fillers (such as Restylane, Juvederm, fat, etc.) are used on static lines/folds or lines that are present even when you are not moving parts of your face.

Around the eyes, Botox is usually only used to reduce the appearance of “Crow’s Feet” which are the lines of movement that you see by the side of your eyes when you smile. Botox would not help reduce the appearance of bags.

A filler, such as Restylane or fat, may be placed along the area where there may be under-eye hollows or dark circles. However, you should go to a highly experienced injector when getting this area filled because this is an area that is not forgiving of improperly placed filler.

Bags under the eye are often caused by fat protrusion and if this is truly the case with you, then the only option would be surgery to reposition or remove the fat through a blepharoplasty procedure. Sometimes what a patient views as “bags” is really not a protrusion, and the surrounding area can be injected with filler to conceal the appearance of bags. Without photos, it is difficult to say which one is your issue. I would recommend you have a consultation with someone who has experience with fillers and surgery, so that he/she can guide you appropriately.

Dr.Sunder