Can Botox Under the Eye Create New Wrinkles in Other Parts of Face?

Can receiving botox under the eye area cause other muscles in the lower face (around the mouth, upper chin) to overcompensate, creating new wrinkles and deeper lines? Do the muscles around the eye interact w/these different muscle groups in the lower face or are they totally independent?

Doctor Answers 9

Botox under the eyes

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I use Botox lateral to the lower eyelids. This prevents the orbicular is oculi from crinkling the skin. There is no overcompensation. When one area of concern in the face is treated, patients become more aware of other issues requiring attention, such as other areas of wrinkling or sagging. I point this out to patients at the time of treatment to avoid such concerns. Given that patients don't have unlimited funds to spend on fillers and Botox, they allocate their money to the areas that disturb them most.

Can Botox Under the Eye Create New Wrinkles in Other Parts of Face?

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No, while Botox injected into the Glabellar area, of the forehead, can cause other wrinkles to appear from over compensation of the eyelid and eyebrow muscles, this does not happen in other parts of the face.  Botox to the lower eyelid should not be able to travel down to the muscles elevating the upper lip.

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

Can Botox Under the Eye Create New Wrinkles in Other Parts of Face?

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Injecting Botox into the muscles around the eyes will not cause other muscles to overcompensate. The muscles around the eyes are independent of the other muscles of the face. You can prove this to yourself by tightening the muscles around your eyes and you will notice that no other muscles of your face contract.  I would caution you however about injecting Botox under the eye as this may cause the lower eyelid to sag.  Injecting along the sides of the eyes in the crow's feet area is a very safe and effective use of Botox.

Donald M. Brown, MD (retired)
San Francisco Plastic Surgeon

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Can botox in one part of my face cause wrinkles in another part?

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Maybe- one common scenario that I see if that people get one area treated and then that area looks great. They then look at the next area over and see wrinkles that are in contrast with the treated areas. They then return to the office and say "Botox gave me wrinkles" -once I show them the photos of their before, they see that the Botox did not give them the wrinkles but rather the treatment enabled them to see an area look good so now there is a contrast.

One other possibility is that in some parts of the face, especially the forehead, Botox creates a compensatory increase in the muscles nearby. I use this to get a brow lift but it could also create some wrinkles in an adjacent area. It should not create wrinkles in an area that is distant.

Kenneth Beer, MD
Palm Beach Dermatologic Surgeon

Botox and under the eyes

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Botox is not usually injected under the eye. Most commonly it is injected along the crow's feet and sometimes in the lateral tail of the eyebrow.  If it is injected too low, it may cause smile abnormalities.

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

Botox Under The Eyes

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Injecting Botox under the eyes should not create new lines in your lower face.  However, when you smile you may notice that the lines around your eyes now look different, and if your crow's feet extended down on your cheeks when you smiled prior to getting your Botox, these may now look more prominent since the lateral lines appear better.

Sheri G. Feldman, MD
Beverly Hills Dermatologist

Botox and eyelid injections

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That is a good question. It should have no chemical effect or muscular effect on other areas of the face where it has not been injected. That being said, depending upon a person's expression and animation, they could possibly use other muscles of expression more and possibly create additional wrinkles. The more likely case; however, is that those other areas become more obvious once the eyelid area looks smoother.

Scott Trimas, MD
Jacksonville Facial Plastic Surgeon
5.0 out of 5 stars 20 reviews

Yes and no.

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Lower eyelid treatment can cause the lower eyelids to slump and create puffiness at the top of the cheek.  This is generally an undesriable results and is the reason that fillers rather than Botox is used to treat the under eye area.

Kenneth D. Steinsapir, MD
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 26 reviews

Treating "Crow's Feet" with botox

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Excellent question.  To begin, we do not use neurotoxins beneath the eye, per say.  When correcting Crows feet, it is very important to stay lateral  (towards the side of your face) and do not inject too low on the periocular muscle to insure that a negative outcome does not occur.  If a practitioner injects too medially and inferior on this muscle, weakening this are of the muscle actually make skin laxity beneath the eye look worse and highlight wrinkles.  If a practitioner injects too laterally and inferior on this muscle, you run the risk of actually hitting the muscle that is responsible for lifting the corners of your mouth, resulting in a crooked smile.  A well-trained and experienced injector knows this and it is generally avoidable.  

Harold J. Kaplan, MD
Los Angeles Facial Plastic Surgeon
4.4 out of 5 stars 7 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.