Bruising under eye after Botox and should ice be used before and after injecting Botox?

It is important to recognize the limitations of BOTOX or other products injected around the eyes.  I often hear of injectors, especially non-physician ones, telling patients that BOTOX will "lift" or "open" the eyes.  However, BOTOX can never do anything other than temporarily weaken or paralyze the muscle it is used to treat.  The only way it can cause lifting anything is by weakening a muscle that is pulling that thing downward.  In very limited circumstances, therefore, a little elevation is possible, but it will be limited.  Similarly, the only way BOTOX could cause the eyes to "open up" is if the muscle it is used to treat is constantly closing them.  There certainly is a muscle, the orbicularis oculi, which contracts to close the eyes, but I would be skeptical about BOTOX treatment making the eyes noticeably more open.Bruising is unusual with BOTOX treatment, but it certainly can happen, especially around the eyes, where the skin is thin and there are often a number of small veins that can be hard to see.  A bruise is caused by bleeding under the skin, and resolves as the body absorbs the blood.  Although I generally do not use ice, some surgeons do. If the vessels are constricted by the ice, it might make them more difficult to see and might increase the risk of bruising, but I am not convinced that that would be a major factor.Unfortunately (or fortunately), there is nothing other than time that will generally resolve a bruise, and while arnica and bromelain have long been recommended, the evidence that they are helpful is weak.Presumably you wouldn't have used the word "injector" if the injector had been a surgeon, or even a physician.  Depending on the state, generally non-physician injectors are supposed to be supervised by a physician, who is responsible for the treatment, and who should be available to help with any problems.  My best advice would be for you to talk with that physician about your concerns.  Otherwise, my advice would be to see a surgeon who can review all of the options available to you.

Botox is used in this area to improve wrinkles associated with hypertrophy of the obicularis oculi muscle. It sometimes forms a roll and wrinkles under the eye and Botox will help. It can't be used in people with laxity in the lower eyelid or they will get ectropian. A snap test is needed prior to test for this. If there is volume loss, filler must be done as well. Ice helps to control bruising for the first couple hours. Bruising should not occur in most cases during this injection with either Botox or fillers if the injector is an experienced one. To expedite resolution of the bruising, I use an Excel V laser and arnica patches.