Botox Didn't Work for Eye Wrinkles - Should I Get Fillers?

Hi team thanks to your responses from my past question - i got botox twice now with a leading surgeon under my lash line and also in my temples to try and weaken the muscle which is causing my horrid eye wrinkles when i smile. The lady has now suggested fillers to plump up the skin under my eye which would result in there not being that fold of skin when i smile as it would be nice and plump. Any comments before i go ahead? thanks team!

Doctor Answers 22

Blepharoplasty, not fillers!

Your photos reveal a candidate for a lower eyeld surgical lift.   You need surgery, fillers will be useless according to your photos.  Get more opinions from 3 ABPS FACS surgeons.   You need more evaluation.   Good Luck.

Palo Alto Plastic Surgeon
4.5 out of 5 stars 36 reviews

Treatment for under-eye wrinkles

This is an excellent case for fillers and Botox. I was the first person to use Botox under the eye for eye widening as well as the first to employ a 32 gauge needle for Restylane in the tear trough. I remember when Michael Kane gave me credit for the latter. First, employ Restylane with a 32 gauge needle  to fill in the tear trough. Then place 2 units of Botox under he skin directly below the pupil. You might just shock yourself on the degree of improvement you achieve.

Arnold W. Klein, MD (in memoriam)
Beverly Hills Dermatologic Surgeon
4.8 out of 5 stars 5 reviews

Fillers can be a good option for wrinkles in the skin

Yes. Fillers can be a good option for wrinkles in the skin, you just have to make sure you are seeing an oculofacial plastic surgeon who is an injectable specialist. You don’t want to go to a dermatoligest to inject filler around the eyes. You need a specialist as the eye area is very delicate and it’s extremely important to find the right physician for this kind of treatment.

Joseph A. Eviatar, MD, FACS
New York Oculoplastic Surgeon
4.7 out of 5 stars 66 reviews

Eyelid Wrinkles

Based on your photos, you would be a candidate for a lower blepharoplasty woth emphasis of removing excess skin. Seek the advice of an eyelid specialist. Good luck

John Pak, MD, PhD
Chicago Oculoplastic Surgeon
5.0 out of 5 stars 8 reviews

Best Treatment for Lower Lid Crepe` Excess Skin...Fraxel repair and/or Lower Lid Skin Pinch

Gid Day Aussie,

You look like you would be an excellent candidate for a skin pinch lower eyelid procedure.  If you wish to treat non surgically and less invasively, then go with Fraxel repair treatment.  If you want to go holistic, try a little Vegemite spread on the lower lids overnight (just kiddin' about that one).  Bee's knees.  Good luck and be well.

Dr. P

Michael A. Persky, MD
Encino Facial Plastic Surgeon
4.8 out of 5 stars 36 reviews

Botox or filler for lower eyelid lines when smiling

Your condition may not improve and could look different and not pleasing secondary to swelling with fillers in the lower eyelids.  Botox can't immobilize the smile muscles which are generating the lower eyelid creases now that the crows feet are treated well. If the smile muscles are treated then you won't move your mouth correctly and your smile and eating and speech will not be good.  Fillers are best to correct lines at rest but if they are used to correct the lines that are visible with movement, then the skin may look lumpy at rest, or there may be too much water retention from the fillers to make the eyelid puffy. Be cautious and conservative.

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

Fillers for Eye Wrinkles

If you're talking about the wrinkles immediately under the lashes of your lower lids, I'd recommend skin excision. If your concerned about the depressions at the lower margin of the lids, fillers would help.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 38 reviews

Beware! Wrong Diagnosis May Lead to Wrong Treatment

It is almost impossible to make an accurate diagnosis of your problem with out examining you because the picture is one static image and the lower eyelid lines most definitely change with your expression, gaze and eyelid position.  That said, I do not believe BOTOX and/or filler is the correct treatment for these lines.  Oftentimes, lines such as yours are caused by buldges of muscle in the lower lid.  These can occur as a result of extended periods of squinting i.e., from inadequate use of sunglasses.  The circular muscle around the eyes can hypertrophy or enlarge, just as a muscle can become more defined as you work out over time in the gym. Surgery is your best bet.  Excess skin and some muscle weakening will likely give you the desired result.  But....don't forget sunglasses!  This is a critical part of the treatment as well!!

Michelle R. Yagoda, MD
New York Facial Plastic Surgeon
5.0 out of 5 stars 5 reviews

Using a filler to elevate cheeks is often the best way to support the skin of the lower eyelid

Using a filler to elevate cheeks is often the best way to support the skin of the lower eyelid. This is because many patients with eyelid wrinkles because of loss of volume of their cheeks.

Edward Lack, MD
Chicago Dermatologist
2.8 out of 5 stars 5 reviews

Botox for Eyelid Wrinkles

Botox is not used for and does not work for the wrinkles you are trying to great.  Botox works by weakening the underlying muscles which softens dynamic (movement) wrinkles in the overlying skin.  Your lower lid wrinkles are more of an anatomic issue which would require a lower lid blepharoplasty to treat.  Injecting filler under your eyelids - in your case - would not solve the problem either.  You do not have a volume deficit which fillers are used to treat.  Botox is a wonderful medication but only when you appropriately.


Good Luck.

David Shafer, MD
New York Plastic Surgeon
4.9 out of 5 stars 75 reviews

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