Under Eye Still Puffy 9 Months After Botox

My colleagues are correct. Botulinum toxin can rarely change the appearance of the lower eyelid (drooping or malposition) but it does not cause bags. Botulinum toxin does not permanently relax facial muscles. Rather, it weakens these muscles for a period of about three months. If you were only treated with botulinum toxin it is highly unlikely that this medication is to blame for the "bag" under your eye. You would possibly benefit from a lower eyelid blepharoplasty to remedy this.Stephen Weber MD, FACS

Michelle

Ouch, 9 docs disagreeing with you.  But they are right.  This is why we take before and after photos.  There is no debate that you may have bags under the eyes but these are normal for someone who is 40 years old.  So now that we have cleared up that misconception, the next question is what are you going to do about your lower eyelid bags?  

My recommendation, lets not throw the baby out with the bath water.  Surgery should not be your first choice.  I would first explore the use of fillers in the under eye area.  This can be amazingly effective for the lower eyelid bags for someone your age.  Also don't give up on BOTOX, it is very helpful along the eyebrow using the patented Microdroplet brow lift method.