After Botox Still Have Wrinkles....will Fillers Help Smooth out the Area?

I am 33 years old and recently had botox for my eye area. Works great for crows feet but I still have plenty of wrinkles under my eyes and right on my upper check just under my eyes. I have very high cheek bones and deep set eyes which leads me to suspect that when I smile the gap between my cheeks and eyes makes the skin crunch up and wrinkle? Would a tiny bit of tear trough filler help smooth out my wrinkles? Or possibly more botox?

Doctor Answers 7

After Botox Still Have Wrinkles....will Fillers Help Smooth out the Area?

Yes use very small unit amounts of BOTOX to improve this but you will ALWAYS have some wrinkling in this area. 

Miami Plastic Surgeon
4.6 out of 5 stars 173 reviews

Botox, restylane, fillers

Botox cannot remove all muscles alone. They must be used in conjunction with fillers like restylane and or lasers to remove resistant wrinkles

Barry Lycka, MD
Edmonton Dermatologic Surgeon
4.5 out of 5 stars 15 reviews

Botox and crow's feet

You could possibly have more Botox injected into that area, and by a well-trained and reputable provider, they may be able to pinpoint other areas that will help settle down those specific lines. A dermal filler helps volumize, the Botox relaxes the muscles.

Sam Naficy, MD, FACS
Seattle Facial Plastic Surgeon
4.7 out of 5 stars 221 reviews

Botox Under the Eyes Combined With A Nonsurgical 3D Vectoring Crow's Feet Lift Can Improve Overall Under Eye Appearance

For the static crow's feet wrinkles that remain on the sides of the eyes and course down the sides of the cheeks after treatment with neuromodulators, like Botox, Dysport, or Xeomin, I have found The Nonsurgical 3D Vectoring Crow's Feet Lift to be particularly helpful and to yield very gratifying results in further smoothing the region.

Using the same principles of vectoring with volumizing fillers (see The Nonsurgical 3D Vectoring Facelift, The 3D Vectoring Necklift, and the The 3D Vectoring Browlift for further explanation), the region over the bone within the fixed (nonmobile) area of the cheek directly in front of the ear is used as an access point to instill "strands," "strains," or threadlike amounts of the volumizer in a fan shape distribution over the mobile crow's feet (periorbital) area and extending onto the cheek.

Requiring only a tiny amount of local anesthesia to numb the entry points, the procedure is relatively painless and takes only a few minutes on each side to perform. As a rule, immediate rounding and greater cheek prominence is seen following the procedure. However, as with the other Nonsurgical 3D Vectoring Lifts, continued improvement is anticipated over the next six to eight weeks as new collagen (neocollagenesis) occurs in response to the presence of the injected material.

The crinkles and bulging under the eyes, largely due to overactivity of the muscle in this area, can be improved with the instillation of a tiny amount of neuromodulator placed into the muscle in the location of the midpupillary line about a quarter of inch below the lashes of the lower lid. 

It should go without saying that consultation and treatment by a board certified aesthetic physician with extensive experience in treating the area around the eyes is an absolute must. 

Nelson Lee Novick, MD
New York Dermatologic Surgeon
4.9 out of 5 stars 29 reviews

Botox around eyes

Botox relaxes muscles. Fillers add volume. What you have under your eyes are active muscles - and not a need for volume. Seek a board-certified experienced injector for Botox to this area.

F. Victor Rueckl, MD
Las Vegas Dermatologist
4.6 out of 5 stars 17 reviews

Botox Around Eyes

From your photos I think you will receive a nice result with adding some more units of Botox around your eyes. Fillers do something different than Botox. Botox will relax those muscles that are causing those little wrinkles. 

Jeffrey Hartog, MD
Orlando Plastic Surgeon
4.5 out of 5 stars 60 reviews

Botox for Crows Feet

Based on the photos provided, you have a very active orbicularis oculi (responsible for eyelid closure) muscle.  A few more units of Botox placed more medially under your eyelids should help to minimize the lines which rest under your lower eyelid.  Fillers can help fill in a tear trough, but do not address dynamic facial lines in this area very well.

Stephen Prendiville, MD
Fort Myers Facial Plastic Surgeon
4.8 out of 5 stars 93 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.