Botox for Undereye Bags?

Can You Use Botox Injections for Undereye Bags?

Doctor Answers 17

Botox for undereye bags

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Hello and thank you for the question.

There is no indication for Botox Cosmetic in the management of under eye bags. Botox may be used for the management of dynamic rhytids under the eyes ( aka "Jelly Rolls"). Keep in mind that this is an off-label use of Botox Cosmetic and I would advise that you seek treatment by trained professionals with significant experience in this area. Under eye bags, in general, are attributed to pseudoherniation of orbital fat. Treatment for eye bags generally requires surgical management. I recommend you consult with a Board Ceritifed Plastic Surgeon for a proper evaluation.


Glenn Vallecillos, M.D., F.A.C.S.

Beverly Hills Plastic Surgeon
4.9 out of 5 stars 30 reviews

Lower Eyelid Bags Result of Herniated Fat & a Lax Orbital Septal Layer

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No, lower eyelid bags are a result of herniated fat and a lax orbital septal layer.  Injecting Botox into this area could weaken the lower eyelid muscle and cause lid malposition (drop).  Lower eyelid bags are removed with lower eye lifts called Blepharoplasty.

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.7 out of 5 stars 28 reviews

Botox is not used for bags under eyelids

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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.

Ronald Shelton, MD
Manhattan Dermatologic Surgeon
4.9 out of 5 stars 39 reviews

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Undereye Bags and Botox

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generally, bags of the eyelids cannot be treated with botox because it will loosen the skin and potentially exacerbate the puffiness as the muscle will have less stregth in pushing the orbital fat backwards. It sounds like botox isnt the appropriate intervention for this issue. COnsider seeking the advice of an ASOPRS-credited oculopplastic surgeon.

John Pak, MD, PhD
Chicago Oculoplastic Surgeon

Botox is not used for under eye bags or hollows. That's for fillers.

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Botox works by weakening muscles of expression to soften dynamic wrinkles. For under eye bags or hollows, this is not helpful. Some physicians are trying to use fillers to camouflage under eye bags, but this may have the effect of making the entire area look too puffy instead of what may instead need a gentle surgical correction. I advise careful research and a few consultations with dermatologists, plastic surgeons, and especially with oculoplastic surgeons, before making a treatment choice. This is a tricky area that can really have problems if there are mistakes.

Jessica J. Krant, MD, MPH
New York Dermatologic Surgeon
4.7 out of 5 stars 41 reviews

Botox for Undereye Bags

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Hi lad68,

This is not the correct indication for Botox.  Many people use the terms "Botox" and "Fillers" almost intrerchangeably, and that's not accurate.  Fillers can be used to camouflage some of the appearance of bags under the eyes (by filling in the areas around the fullness) but if there is enough fat it may be advisable to have that removed, in addition to (or instead of) the fillers.

Botox, on the other hand, works by relaxing muscles and, therefore, the lines that are caused when those muscles contract.  It is used most commonly for the lines between the eyes, on the forehad and at the sides of the eyes, though it can be used on many other areas.

For the bags under the eyes, though?  Not really...

I hope that this helps, and good luck,

Dr. E

Botox for under eye bags?

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Simply, no. Botox works by relaxing facial muscles that contract and cause wrinkles. For under-eye bags, we can use fillers sometimes to replace fat that is missing or we can repair them with surgery.

Andrew Kaczynski, MD (retired)
Sacramento Plastic Surgeon

Botox can be used to relax wrinkles under the eyes but not for undereye bags

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Under eye bags are caused by thinning of the skin and connective tissue which leads to the protrusion of the fat beneath it. 

Botox is used to relax muscles in order to smooth wrinkles.  Muscles are responsible for horizontal creases immediately under the rim of the lower lid, and those can be relaxed.  However, there is no muscle involvement in the formation of under eye bags, therefore Botox would not work.

Emily Altman, MD
Short Hills Dermatologic Surgeon

Botox for lower lid bags

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Botox will not help lower lid bags, it in fact can make it look worse. Your options are lower lid blepharoplasty or Juvederm injection around the bags to blend them.

Peter T. Truong, MD
Fresno Oculoplastic Surgeon
4.9 out of 5 stars 42 reviews

Botox for undereye bags...

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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. 

Andrew Miller, MD
Edison Facial Plastic Surgeon
4.8 out of 5 stars 222 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.