Can Botox Fix Tear Trough Wrinkles?

Question

I have what I call, 'gravel' between my nose and under my left eye. It appears that it's a result of my 'fat' fleshy face being mashed as I sleep on my side. Can Botox help with these funny looking wrinkles?

Richard Baxter, MD · Answer

Hollowing in the tear tough area may be corrected with either a blepharoplasty or addition of volume with a filler. In fact the lack of volume is the reason there is a "trough." There is a related condition along the side of the nose, so called "bunny lines" that can be treated with Botox but that is a separate issue.

Steven H. Williams, MD · Answer

Thanks for your question -
Botox works by paralyzing muscles that when they contract create wrinkles.  In the area you describe is part of the orbicularis muscle around your eye.  In this portion of the eye the wrinkles you see are more likely to be caused by loose skin or by herniating fat than by the muscle contraction.
This means that Botox is unlikely to be a good solution.  
These areas typically require surgery or ablative laser treatments to remove or tighten the underlid skin.
I hope this helps.

Michael A. Persky, MD · Answer

Hi bt,
Botox works on the "bunny" lines on the sides of the upper nose by relaxing the muscles that cause the lines.  In your case, I do not believe that Botox will treat help with the "gravel, mashed excess skin from sleeping". 
A filler or "skin pinch" procedure in that area would likely be better choices.
Be well.
Dr. P

Bryan K. Chen, MD · Answer

I suggest you consult with a board certified facial plastic surgeon or dermatologist for a face-to-face consultation.  Frequently such consultations are free.  Generally speaking, Botox can help with muscle contraction-related wrinkles on the sides of the nose ("bunny lines").  Botox for wrinkles of the lower eyelid is somewhat tricky and can in certain cases make wrinkling or hollowing appears worse.  Re-surfacing procedures, laser or chemical can help with lower eyelid wrinkles and may be a good option for you depending on what your problem is.
Good luck.

George J. Beraka, MD (retired) · Answer

Hi! This is a difficult area, but it can be improved with Restylane or fat injections or lasers or surgery, depending on the exact anatomy. You need a very sophisticated doctor. Go to a board certified plastic surgeon and ask to see lots of before and after pictures.

Arnold R. Oppenheim, MD (retired) · Answer

If you comb this website you will read a number of woes when Botox is adminstered around the eyes. Often, Botox will make this area baggier. Botox can address "crow's feet" and can be used, when placed judiciously, to enlarge the eyes.
    Perhaps, you might have the tear trough treated with a filler such as Restylane, but Botox would be out.
   From what I am envisioning, however,  you might be better served with a blephoraplasty. I would consult a plastic surgeon, board certified of course.

Can Botox Fix Tear Trough Wrinkles?

Answers (6)

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