Swollen under eyes, 12 hours after Botox

What would cause severely swollen eyes after Botox. I had botox injected in crows feet and closely above the eyebrow. (5 units on each side of crows feet) It's as though water is holding around the eye, particularly under the eye. The area also has a purple tint. Please note: I Never have eye bags, so this is something very obviously related to the botox. Could this be water retention from a lax muscle, only 12 hours after injection? When should this go away? Is there anything I can do to fix it?

Doctor Answers 12

Swelling and bruising after Botox

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Thank you for your question. Most probably your swelling and bruising are the result of the needle piercing a blood vessel near the eye. You may ice the area until to help minimize this. Please remember final results take up to weeks. Best of Luck!

Summit Emergency Medicine Physician

Swelling and bruising after Botox

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Thank you for your question Anna B. I am sorry to hear about your situation. Botox is a purified protein used to address wrinkles associated with facial expression such as the crows feet one sees when one smiles. Bruising and swelling are possible after any injection and are most common around the eyes because there are many blood vessels there. The blood from a bruise may leak into the surrounding tissue and cause swelling. When this happens the area may have a blue or purple tint. Application of cold compresses can help reduce swelling. Please follow up with your doctor for specific recommendations. Good luck!

Bruising Prevention with Toxin and Fillers

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
In order to mimimize potential bruising, avoid the following products 7 days prior to treatment and for up to 7 days after treatment: Alcohol, Aspirin, Vitamin E, anticoagulants such as Plavix, Coumadin, Fish Oil, St. John's Wort, Ginkgo Biloba, Ginger, Garlic, Feverfew or non-steroidal anti-inflammatory products such as Ibuprofen (Motrin, Advil) or Naproxen (Aleve, Naprosyn). If bruising is persistent or you are worried, set up a follow up appointment with your dermatologist. Cold compresses may be used immediately after treatment to reduce swelling only if needed. This may be applied for 3 minutes, 3 times per day, for up to 3 days. This is best done with a bag of peas in a zip lock bag. Only apply light pressure to the area.

Alim R. Devani, MD, FRCPC
Calgary Dermatologist
4.9 out of 5 stars 16 reviews

Botox and Swelling

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

It is possible that the swelling and bruising is as a result of the needle piercing a blood vessel around the eye.  I would recommend icing the area and the full results with take up to two weeks to assess.  Best, Dr. Green

Swelling and blue tint after botox

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
I have never seen Botox work after only 12 hours.  I have also never seen an allergic reaction to Botox.  My only possible explanation would be either bruising, or swelling from the trauma of the needle.  Especially since you are seeing some blue tint (without an examination, my hunch is purely from process of elimination). I would also wonder if the Botox was reconstituted with something other than normal saline, that could possibly give you an allergic reaction?  Or maybe a numbing cream that was used?  Are you allergic to anything?  I highly recommend for you to go back to your injector and brainstorm, as you should know if you have any allergies.

All the best!

Sherly Soleiman, MD
Encino Physician

Botox and Swelling

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
Botox can lead to swelling under the eyes which can last a few weeks.  I suggest venus legacy treatments and fingertip massages.  Best, Dr. Emer.

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.8 out of 5 stars 207 reviews

Botox effect takes a few days to start

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
It is likely that is related to the needle injection, and not the Botox, but I cannot comment without examination or photos.

Mehryar (Ray) Taban, MD, FACS
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 91 reviews

Swelling after Botox

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
Thanks for the inquiry,
l am sorry to hear about this. In general with any injection around the eyes you can expect some degree of swelling and bruise particularly if very small blood vessels get hit. Icing can be helpful in the first couple of hours following the injection and it is best to contact your surgeon who knows you and your anatomy well after any unusual reaction to Botox or fillers.

Jacob Sedgh, MD
Los Angeles Facial Plastic Surgeon
5.0 out of 5 stars 22 reviews

Swollen under-eyes not typical after Botox

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
The swelling that you are describing is very unusual.  I wonder if you are swelling from the trauma of the injection?  Or, if you may have a deep bruise, thereby giving the purple tint?  Both are unusual since we usually use very fine needles to inject botox and the injection is very superficial (just under the skin).  

Did you have anything else done?  Filler injection could cause swelling and, if the injection is too superficial, it can cause a purple tint.

Please call your injector and describe your situation.  

Swelling after Botox

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
Significant swelling after Botox is rare, especially with the small amount that you got. You may be bruised or have a small hematoma from the injection itself. Best to follow up with your injector. Best wishes. 

Michael A. Zadeh, MD, FACS
Sherman Oaks General Surgeon
5.0 out of 5 stars 10 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.