Botox or fat injection for under eyes?

i want to smooth out the look under my eyes and I'm not sure if i should do botox or fat injection please help, the picture to the right is untouch and the picture to the right is photo shop of how i want my under eyes to look like, Thanks

Doctor Answers 10

Botox vs. Fat Injection Under Eye

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Most patients complain of a tired look due to a concavity of tissue in the tear trough region under the eyes. Fillers or fat injections will be the treatment to correct this issue if desired.

Los Angeles Plastic Surgeon
4.4 out of 5 stars 69 reviews

Cosmetic Eye Procedues

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Depending on several details you might benefit from fat transfer and/or fillers.  Would have to see you to give further suggestions

Paul Carniol, MD
Summit Facial Plastic Surgeon
5.0 out of 5 stars 8 reviews

Under eyes

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There are many factors that contribute to uneven skin texture under the eyes. I would recommend having a consultation with a board-certified physician to discussed the options- many times there isn't just one treatment regimen. 

In general- fillers or fat transfer may be useful for fat loss, but in some cases these can exacerbate the issue depending if you have any protruding fat pockets under the eyes. Lasers can be helpful for wrinkling under the eyes as well.  

Do not forget the importance of healthy daily living- untreated allergies, not sleeping well, stress, and poor diet can all show under the eyes quickly.
If it is severe ( I can't see the photos)- you may decide to have a lower blepharoplasty with an oculoplastic surgeon.
Good Luck!

Sandra Kopp, MD
New York Dermatologist

Smoothe eyelid skin with Botox, fat graft and other options

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Dear skky35:

Your photos did not come through. 

Cosmetic improvements of the face, including the eyelids takes a full spectrum understanding of the art and science of Botox, fillers, peels, lasers, fat grafting, skin, anatomy and surgery. 

In general, Botox nor fat grafting are recommended under the eyes. Botox may weaken the muscle creating the line or wrinkle but also allow swelling or the fat bags to protrude and round the lower lid appearance. 
I have found survival of fat under the eyelid to be unreliable and lead to bumpiness or nodularity. 

Fillers may smooth or add volume.
Peels and lasers may tighten or exfoliate the skin to create smoothness.
Surgery will redrape the skin and remove skin excess.

Each takes talent and skill. Please obtain consultation from a Board Certified Plastic Surgeon or Ophthalmologist who is well experienced in all these options so they match what is best for you.

All the best!

Dean P. Kane, MD, FACS
Baltimore Plastic Surgeon
4.9 out of 5 stars 103 reviews

Botox vs. Fat Injections

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Thanks for your question. In order to give the best diagnosis and course of treatment, we would recommend you post pictures or schedule an appointment with a board certified plastic surgeon and one who is a member of the ASPS. Botox vs. fat injections are two very different treatments both which can provide great results for smoothing out the look of your skin. Best of luck to you. -Dr. Coan.

Brian Coan, MD, FACS
Raleigh-Durham Plastic Surgeon
4.9 out of 5 stars 65 reviews

Eyelid issues

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Do you have wrinkles or depressions or both?  Best to be seen in person. Botox will not improve lower lid wrinkles and may cause weakness. Sometimes fillers are used for depressions.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Eyelid Wrinkles

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Without pictures, it is difficult to give you sound medical advice. Depending upon the problem, you may be a candidate for botox, a filler, and /or a chemical peel. 

George C. Peck, Jr, MD
West Orange Plastic Surgeon
4.8 out of 5 stars 25 reviews

Under Eyes

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I do not see any photos attached.  For under the eyes I recommend Restylane.  It smooths hollows and lasts about a year in this area.  Botox is not used under the eyes.

Jessica Lattman, MD
New York Oculoplastic Surgeon
4.7 out of 5 stars 29 reviews


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I do not see a photo. Thus it is impossible to say -- but in general, stay away from fat injections around your eyes. Botox paralyzes muscles and decreases your wrinkling, so to really find out, get a consultation with a board certified plastic surgeon to know for sure.

William B. Rosenblatt, MD
New York Plastic Surgeon
4.2 out of 5 stars 12 reviews


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lower eyelids hollowness and skin discoloration are very common presenting problems in my practice. the best way to take care of patients concerns is to assess the underlying problem at first. if its a matter of hollowness then filler or fat injections are the way to go. if its a matter of skin discoloration then i would recommend lasers. best would be to have yourself evaluated first then let the doctor decide whats best for you.  

Misbah Khan MD, FAAD, FACMS
New York Dermatologic Surgeon
4.9 out of 5 stars 32 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.