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

I have used Botox beneath the eye with mixed results.  Some people like it, most find it to be an uncomfortable waste of time and money.  Pinch blepharoplasty, an abbreviated type of lower eyelid surgery (local only, no anesthesia recovery) is often the answer.  It's long lasting (years) and does a lot more than Botox in this area.  My website has before and after photos of Pinch Blepharoplasty.  

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

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.

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.

Dear KSG

One needs to be exceptionally careful with both under eye BOTOX and under eye fillers especially since no one wants a treatment that makes them look worse.  The issue with under eye BOTOX (any BoNTA) is that one can weaken the muscle right under the eyelashes that holds the eyelid up.  This can cause the eyelid margin to fall or slump-not good.  This type of treatment can be done by it is really an advanced technique.  FIllers are generally a better alternative.  However, this is also an advanced form of treatment that requires both experience, a detailed understanding of eyelid anatomy, and the eye of a sculptor.  That is by way of saying that not everyone does as good a job.  In terms of which filler, Restylane is the product of choice for this location.

I read your concern and reviewed your photo. The bunching of skin below your lower lash-line is a difficult problem to fix. I have not had favorable results with Botox, which is similar to your experience. In my view, Injectable Fillers are helpful for lower eyelid grooves that are below a lid-bag. I would not advise getting fillers under the wrinkled skin (orbicularis roll). My hunch is that you will not be pleased by the result.

Regards from NJ:

By your photo, I would consider a pinch procedure to rid you of your wrinkles. If you had a trough under the eye, then fillers are great. If you were not smiling in the photo, you have excess skin in the lower lids. This can easily be treated by simply removing the excess skin using local anesthetic. The resulting scar is virtually invisible.

Andrew Campbell, M.D.

Board Certified Facial Plastic Surgeon

As long as the surgeon does this a little at a time you should do well. If too much is put in you will have a lump.

Hi KSG.  Based on the photo you submitted, we think you are a good candidate for "tear trough" injections, which is the name of the procedure for filling the under eye.  

We cannot see what the crow's feet (sides of eyes) looked like while smiling so it is possible you received some benefit from the Botox from those injections, but Botox would not help under the eyes.  We use Restylane and you can view before and after pictures of tear trough injections at the link below.  Good luck.

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.