Is Botox or Juvederm a Better Solution to Get Rid of Under Eye Bags That Make Me Look Tired?

I just turned 30 and under my eyes I have little bags. Sometimes is not as bad as others. Some days it doesnt go away at all though.

Doctor Answers 21

Botox for Undereye Bags

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Undereye bags are either caused by fat pads protruding (which can be treated with a blepharoplasty to remove it) or hollow tear troughs (which could be treated with a filler like Juvederm or Restylane). Botox is a muscle relaxant, and should never be used under the eye (nor would it help under eye bags in any way). Hope this helps. 

New York Dermatologic Surgeon

Botox under the eyes

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Botox cosmetic is not ideal for treating under the eyes.  The unwanted lines are not always dynamic (caused by muscle movement) and often redundant skin is present.  We have found much more success with monthly platelet rich plasma injections, for 4 months.

Puffiness can be treated with surgical removal of fat, wrinkles and extra skin can be treated with platelet rich plasma injections.

Charles E. Crutchfield III, MD
Minneapolis Dermatologic Surgeon

Treating bags under the eyes

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Your dermatologist should examine your particular case to give you the best treatment options. Generally speaking, I don't find Botox of much use for this problem. If there is a true swelling of eyelid bulge, then often a blepharoplasty is required to reduce the bulge or remove excess skin. In some cases, there is a deep groove under the eye called a "tear trough" which can be filled with a filler like juvederm or restylane to lessen the appearance of the bulge.

Benjamin Barankin, MD, FRCPC
Toronto Dermatologic Surgeon

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Botox vs Juvederm for under eye bags

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Juvederm will plump the transition line between where the lower eyelid ends and the cheek starts- that may improve the contours of your "under eye bags."  Botox will paralyze the muscle that causes some of the wrinkles around the outer corner of your eye but really doesn't address more than wrinkles around your eyes that are formed when you smile.  Make sure you are going to an experienced injector when your doctor is offering botox injections on the eyelid muscle within the bone limits of your eye socket. 

You also may consider laser peel or chemical peel resurfacing to tighten the skin around your eye.  Finally you may consider eyelid lift surgery to remove the bags permanently and tighten the skin in the same procedure. 

Bags under eyes are often from volume loss

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Under eye puffiness or bags is a problem with many causes. Often it is easily diminished by restoring the lost volume in the areas adjacent to the bags.

Fillers such as juvederm or restylane are good for this area. Botox would not be appropriate.

These measures are often the first step, with surgery as a back up plan. 

Christopher J. Peers, MD
South Bend Facial Plastic Surgeon

Treatment of eyelid contour problems

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The problem you are describing may result from pseudoherniated fat or swollen tissue creating a bulge.  These problems are usually managed surgically.  It may be that you have a volume deficit in the midface immediately beneath the eyelid which is improved with volume enhancement from fillers.  You should consult with an experienced eyelid surgeon to discuss which options are appropriate for you.

Mark Beaty, MD
Atlanta Facial Plastic Surgeon
5.0 out of 5 stars 24 reviews

Eye bags and treatment

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If you have herniated fat in the lower lids, then it is probably best to have a conservative lower lid fat removal.  Sometimes this can be combined with later treatment using fillers to camouflage the tear trough region as well.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Treatment of Eye bags

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It is almost impossible to give you specific advice with out pictures.

in general a young person maybe treated with filler such as Restylane for tear trough deficiency or hollowing of the orbit. Botox or Dysport are used to treat wrinkles such as crow feet or  wrinkles of the Eyelids.


Please post pictures.


Good luck !!!

Is Botox or Juvederm a Better Solution to Get Rid of "Under Eye Bags"?

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Juvederm is a very good option typically for under eye bags. Especially in younger people who want to avoid surgery (the only permanent solution to this problem). Botox, on the other hand, is a BAD option here. Botox in the area of the lower eyelid bag will make this problem worse and if overdone can even cause the lower eyelid to droop. Seek an experienced injector as this is injection area requiring advanced training and experience.

Stephen Weber MD, FACS

Botox or Juvederm for under eyes

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Both will help or none will help.

By this, I mean that it is possible that both products are required: Botox to relax the muscle that is causing you to wrinkle and Juvederm or Restylane to fill the sunken area around the eye. Alternatively, it is possible that your lid is too loose and needs to be surgically tightened. Certainly, it is reasonable to try a non invasive approach such as Botox or Restylane and see how much improvement you get.
It is important to realize that injections into this area produce bruising and are among the least predictable so that even experienced injectors may not deliver exactly what you are looking for (injectors with a lack of experience should be avoided)

Kenneth Beer, MD
Palm Beach Dermatologic Surgeon

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.