Can Botox/Dysport help with my under eye wrinkles? (Photo)

I am 39 years old and have never had any botox or fillers. For the most part, I don't have very many wrinkles, but lately when I smile I am really bothered by the wrinkles that form under my eyes. They aren't really crow's feet at the side of my eyes, but rather deep wrinkles under my eyes towards the top of my cheeks. I have read many answers on here and feel like there are many conflicting answers as to whether botox or dysport can safely and effectively treat this area.

Doctor Answers 10

Eye Wrinkles and Best Treatment

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It would be best to post a photo.  eMatrix has a special tip to help with the tiny lines under the eyes and has great results.  Botox is great for Crow's feet  but not for the lines under the eyes.  You may also benefit from a filler such as Belotero or Restylane.  Please consult an expert in these delicate injections.  Best, Dr. Green

Can Botox/Dysport help with my under eye wrinkles?

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Unfortunately, you do not have photos available in order to give you better recommendations. Based on what you wrote and with no facial exam; I think that what you are describing is excess skin when you smile as the smile muscles drive skin upward into the lower eyelid area. As we all age, this excess skin combined with the loss of elasticity transform into wrinkles of the lower eyelid.

This problem is not helped by Botox, as many other physicians have mentioned. Al typically recommend resurfacing for my young patients that have this problems. A chemical peel or a fractional CO2 resurfacing (ActiveFX) will help to tighten the skin in the area. It will not help with the hollow eyes if you have some. If the amount of skin is considerable, then a skin pinch excision can be done, but this will leave you with a small scar that is easy to conceal.

Hope this helps,
Dr. Gus Diaz

Gustavo A. Diaz, MD
Charlotte Facial Plastic Surgeon

Dark Circles, Eyelid Wrinkles/Bags Treatment -- Voulma/Restylane/Belotero with Cannulas, Clear+Brilliant, Eclipse Micropen, Viva

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Botox is not that beneficial for under eye wrinkles and in some instances can worsen it.  Fillers, lasers, skin care and microneedling are the standard in our practice.  Best, Dr. Emer.

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.8 out of 5 stars 203 reviews

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Botox or Dysport for Under Eye Wrinkles

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 Xiola24 Botox or Dysport can decrease the pull of the oricularis muscle around the eye.  this muscle causes the overlying skin to squeeze.  While it can diminish this muscle pull the overlying skin may have lost too much elasticity and you may or may not see and tightening of the skin.  Also if the muscle becomes too weak , this can cause tearing and irritation to your eyes.  A full consult is necesssary but you may do better with skin tightening and laser resurfacing.  Please see attached video.


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Botox works great for the fine wrinkles that are created by the muscle contraction lateral to the eyes and in other areas. However, it sounds like you are mostly concerned with the deep wrinkles that form under your eye when you smile. It sounds like this would be better treated with a filler and something  to improve the skin quality of that area. At 39 years old it is likely that you could benefit from the filler.Good luck! 

Can Botox/Dysport help with my under eye wrinkles?

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Without a photograph available it is especially difficult to make a cogent recommendation. I would have you consider conservative injection of botulinum toxin so that you can see the benefit and judge for yourself whether it is worth repeating. As long as not overdone, the injection is relatively safe. Injecting too high or too much botulinum can result in weakness of the lid that may last for months and needs to be avoided.
Meet with a plastic surgeon in your area familiar with these treatments to discuss the option that is best for you. I always explain to patients that the lower eyelid skin is the 2nd thinnest of the body and muscles of expression are essential to maintain. Consequently some wrinkling with expression is to be expected and must be accepted. Good luck and best wishes.

Jon A Perlman, MD FACS
Diplomate, Am. Board of Plastic Surgery
Assoc. Clinical Prof. of Plastic Surgery, UCLA Medical Center
Beverly Hills, Ca

Jon A. Perlman, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 31 reviews

Botox for under eye wrinkles

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Botox can help under eye wrinkles, but not in everyone. Basically, there are two reasons for under eye wrinkles, excess muscle activity, or excess / poor quality skin. The prior can be treated with Botox, the latter can not. If you have excess skin and it is bunching when you smile because the cheek lifts, then excision of the extra skin or laser tightening of the extra skin would be necessary. If excess muscle motion is contributing to the wrinkles, then Botox can help. An experienced surgeon can usually tell what the problem is during an examination. If a patient really wants to avoid a minor surgery, or lasers, then I usually recommend they try the Botox as there is very little risk, and if it works, great!

Andrew Campbell, M.D.
Facial Plastic Specialist
Quintessa Aesthetic Centers

Andrew Campbell, MD
Milwaukee Facial Plastic Surgeon
4.7 out of 5 stars 25 reviews

Can Botox/Dysport help with my under eye wrinkles?

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Thank you for your excellent question.  Nothing replaces an in-person examination but wrinkles that form towards the lower, outer portion of the eye can be effectively treated with Botox, and even along the under eye area if an exam shows you to have a thickened/over-active eye muscle that contributes to your current appearance.  Oftentimes wrinkles that develop along the upper part of the cheek due to having a big smile can be improved with filler placement but often does not go away fully as the wrinkles form as a result of your skin folding.  Your question requires a thorough examination to offer the best treatment advice, so see an ASPS board certified plastic surgeon in consultation.  

Botox issues

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Without pictures, it's difficult to say what you would really need. However, it certainly sounds like from your description that Botox is not the answer. You may need a laser or chemical peel application. You may also need a lower blepharoplasty to address your issues. You should see a facial plastic/plastic surgeon for an evaluation.

Robert J. Smyth, MD
Cincinnati Facial Plastic Surgeon

Under Eye Wrinkles

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Thank you for your question.  Yes, a small amount of Botox 2-4 units can help with the "crepe" or "Krinkle" skin under the eye with movement.   Don't be surprised if your injector also suggests some to the crows feet area as this can also contribute to the under eye wrinkled skin.  Please see an experienced injector!!  Thank you! Best!

Paul E. Goco, MD
Nashville Facial Plastic Surgeon
4.5 out of 5 stars 8 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.