I have recently had 45 units of Botox in forehead and eyes. I still have deep lines under my eyes which I hate. (Photo)

How would I get rid of these lines under the eye? Would a filler help to eliminate these?

Doctor Answers 23

How to improve lines under eyes even after Botox?

You appear to have a small amount of protruding fat under your eyes as well as some lines above and below these areas.  It is possible that a filler could help to improve these issues. Surgery of the lower eyelids would be another option.  If you were to use a filler, I would recommend one of the hyaluronic acid fillers, such as Restylane for that area.  


San Francisco Facial Plastic Surgeon
4.5 out of 5 stars 18 reviews

Lower Eyelid bags

It never makes sense to me to add volume into an area that it already too protuberant. Therefore, fillers would make these lower eyelids even more bulbous. On the contrary, standard lower blepharoplasty would be beautiful, refreshing, and not have to be repeated every year or so, which makes lower eyelid surgery  predictable.  It doesn't add bulk and it saves money  b/c it doesn't have to be injected over and over again.

Larry C. Leverett, MD, FACS
Phoenix Plastic Surgeon
4.7 out of 5 stars 17 reviews

Fraxel laser helps wrinkles under eyes

Aside from Botox to smooth your crows feet and Restylane to fill in under eye hollows, thinning skin can benefit from Fraxel laser.  Fraxel will smooth the skin and thicken up the dermis by stimulating collagen growth in the skin.  I call these 3 eye treatments my "BFF": Botox, Fillers and Fraxel!
You should also use sunscreens daily and a strong, effective eye cream daily, such as SkinMedica TNS Eye Repair, Skin3 eye cream or RestoreSea Eye Blur.

Lorrie Klein, MD
Laguna Niguel Dermatologic Surgeon
4.9 out of 5 stars 214 reviews

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Still have wrinkles after Botox

Thank you for your question pollycam. Botox is used to treat wrinkles around the eyes. A tiny amount of Botox injected directly under the eyes can be used to treat fine lines in that area.
Volume loss under the eyes is common. This is more apparent when the wrinkles are treated because sometime we do not notice it when we see wrinkles. Volume loss can be treated non-surgically with a filler such as Restylane. Surgical options would have longer lasting results. I recommend consulting with a doctor for specific advice. Good luck!

Alex Eshaghian, MD, PhD
Encino Physician
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Undereye lines and hollows after Botox injection

I believe combination treatment works best in this area and I will often use fillers to help with undereye hollows, Botox to the inferior aspect of the orbicularis muscle to help with the dynamic lines (although this is an advanced technique that should only be done by an experienced injector in the appropriate patient), and lasers and/or microneedling to help with skin laxity and textural issues. 

In your case, it appears that you have had filler in the midface (cheeks) and this seems to have accentuated the hollowness around your eyes. I would almost certainly recommend a hyaluronic acid based filler like Belotero or Restylane to the tear troughs and along the orbital rim if you were my patient. 

Shaun Patel, MD
Miami Physician
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Dark Circles, Eyelid Wrinkles/Bags Treatment -- Restylane or Belotero with Cannulas, Clear+Brilliant, Eclipse Micropen, Viva

I suggest a combination approach with lasers, fillers, skin care and microneedling/PRP for treatment of under eye wrinkles and optimal results. Please see a board certified dermatologist. Best, Dr. Emer.

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.9 out of 5 stars 188 reviews

Lines around the Eyes

Botox has a great result for the crow's feet but the area that you are describing would be best treated with a combination of lasers and fillers.  I like the eMatrix for this delicate under eye area and Belotero or Restylane as a filler.  Please consult an expert.  Best, Dr. Green

Michele S. Green, MD
New York Dermatologist
5.0 out of 5 stars 69 reviews

Lines underneath lower eyelids

Thank you for your question.

For deep lines underneath your lower eyelids, there are a combination of procedures that can be performed to help this area. Frist, the use of peels or laser therapy can diminish the lines underneath the eyes. Second, fillers in this area, when placed correctly, can soften the lines. And lastly, a lower eyelid blepharoplasty is an excellent option to remove excess protruding fat and redrape the skin of the lower eyelid-cheek junction. Hope this helps. Best of luck.

Manish Champaneria, MD
Portland Plastic Surgeon
5.0 out of 5 stars 53 reviews

Lower lids

It is very hard to see the lines in the photos. If they are fine lines. then light peels or laser may help.  If you are concerned about tear troughs, then filler might be good.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 26 reviews

Restylane and laser resurfacing under the eyes.

Hi Pollycam.  You are definitely a candidate for Restylane injections and have some volume loss under the eyes.  Laser resurfacing can also help with those lines.  See below for photos and further explanation.

Harold J. Kaplan, MD
Los Angeles Facial Plastic Surgeon
4.3 out of 5 stars 6 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.