Will Botox Work for Lines Under the Eyes?

I am not concerned with my crows feet as much as the lines that are under my eyes. They are deep even when I am not smiling, which is when they are the worst! Would Botox work for lines underneath my eyes?

Doctor Answers 14

Botox and fillers together work well for under eye wrinkles

Botox only works half of the time for dynamic lines under the eyes, but when it works, it is very nice. Often fillers such a restylane, juvederm or diluted radiesse work well for the stationary lines under the eyes but should be done in 2-3 sessions and are combined with the botox to give optimum results.

Botox $300; restylane or juvederm $550 / syringe; radiesse $630 per syringe.

Beverly Hills Dermatologic Surgeon
4.7 out of 5 stars 42 reviews

Botox under eyes

Thank you for your question and for sharing your photo. Botox may help to soften the wrinkles under the eyes. It does require a very small amount and it will help to soften the lines. It will not necessarily reduce all the wrinkles like you might see in the forehead or crows feet region. You will notice a soft relaxation of the dynamic lines under the eyes, and you may notice a slight opening of the eyes. I would start with 1-2 units under the eyes on each side. If you like the effects, then it is very easy to incorporate this into your future treatments.

Dermal fillers such as Restylane can be used to fill in shadows under the eye and achieves a more rested look. You can combine the two treatments but it would require a thoughtful approach and careful analysis of your concerns to ensure that treatment options will help you achieve your goals.

I would recommend visiting with a board certified plastic surgeon or dermatologist in your area to address your concern as it is an advanced area to treat.

Young R. Cho, MD, PhD
Houston Plastic Surgeon
4.8 out of 5 stars 37 reviews

Botox under the eyes definitely worth a try

For the area beneath the eyes very little amount of Botox is needed.

If this, however, did not work for you, a Hyaluronic based filler such as Prevelle or Resylane may help those lines.

Finally, other procedures such as chemical peels or Fraxel CO2 repair may help if Botx and Fillers were not adequate.

Nissan Pilest, MD
Irvine Dermatologic Surgeon
4.7 out of 5 stars 19 reviews

Botox for wrinkles under the eyes

Botox may be beneficial to address wrinkles under the eyes depending on their severity. Fines lines located on the lateral aspect under the eyelid tend to respond better than those in the middle.

Sometimes the addition of a chemical peel will help smooth the wrinkles out more. If your lines are deep while at rest or do not respond to these other methods, you may require treatment with a laser.

My advice is to start conservatively and work your way up to more aggressive, expensive treatments if needed.

David A. Robinson, MD
Munster Plastic Surgeon
4.7 out of 5 stars 42 reviews

Botox not the usual best choice for under eye lines

As you know, Botox works by relaxing hyperactive muscles that cause wrinkles by repeatedly folding the skin. Crow's feet are an excellent example of this, but under eye lines are usually not. There are some people who have a hyperactive muscle just below the eyelashes, but this usually appears as a bulge rather than deep lines. I suspect that the lines you are seeing are caused by skin laxity and so would not be helped by Botox. An eyelid tuck (blepharoplasty) or a chemical or laser peel are the usual first lines of approach there.

Richard Baxter, MD
Seattle Plastic Surgeon
4.9 out of 5 stars 52 reviews

Botox for the lower eyelids

If the lines are present at rest, as in your situation, then Botox may not help that much, compared with resurfacing for photodamage-induced lines. This can be done by fractional Fraxel laser or chemical peels. Fillers may look lumpy in this area or may be visible because of the thin skin. Some patients who do have lines underneath the lower eyelids when smiling can obtain a nice result with very small units of Botox as long as there is no tendency for puffiness (the lack of muscle movement after Botox could minimize the draining of fluids and if one is prone to puffiness of the lower lids, then it could be compounded). Also, some patients have poor skin tone of the lower eyelid and the lid can be made to drop if Botox is injected there. That can create a dry feeling of the eye.

Ronald Shelton, MD
Manhattan Dermatologic Surgeon
4.9 out of 5 stars 37 reviews

Botox and other options for under eye wrinkles

Botox would probably soften some of these lines, i.e. make them less deep & less in number. A very valid option is a chemical peel with 35% TCA or a phenol peel that is specially formulated for the thin eyelid skin.

Fractional laser may be another alternative. The trick is to be onservative so as not to end with "ectropion" with "show" of the white of the eye.

Khaled El-Hoshy, MD
Detroit Dermatologic Surgeon

Botox under eyes might work

if injected by a physician experienced in treating this area of the eyelid. Small amounts of Botox placed carefully under the eyelid work quite nicely. Be sure that you receive treatment from a doctor familiar with the anatomy and functional physiology of the eyelid musculature. I would recommend a board certified plastic surgeon. Good luck!

Kenneth R. Francis, MD, FACS
Manhattan Plastic Surgeon
4.6 out of 5 stars 47 reviews

Botox for lines under eyes

The other answers are all correct just a couple points:

1. I do think its worth a try with Botox to get rid of the most laterally located lower wrinkles...I definitely have patients for whom this has worked well. The more midline wrinkles aren't appropriate for Botox

2. I would do the Botox first before doing the filler. You may find you need less filler once the resting muscle tone is diminished by the Botox.

My two cents.

Robert Frank, MD
Munster Plastic Surgeon
5.0 out of 5 stars 34 reviews

Botox for lines under the eyes

Hard to be sure the exact area of the lower lid you are asking about. Without a photo, my recommendation is to try a very low dose by an expert Botox injector to see if it works for you. Costs should only be around $200 to $300.

If not happy, it will wear off within a few months.

Regards from Miami

Darryl J. Blinski, MD
Miami Plastic Surgeon
4.6 out of 5 stars 173 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.