Will Botox help for under eye lines and sunk in look on the eyes? (Photo)

My eyes always appear tired looking. Lines under the eye with a little sag. They also has this sunk in look with a little bite of darkness under the eye.

Doctor Answers 17

Sunken under eyes

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Botox and dysport work on the fine lines around and under the eye.  They can cause some lifting of the brow and some opening of the eye.  However, these products do not help with a sunken under eye or discoloration.  For treatment of this a hyaluronic acid filler like juvederm, restylane, or belotero would be best.  Make sure to go to an expert injector as this is an area that is frequently done wrong.  Also, be aware the filling the under eye area may make the discoloration more obvious since it will be lifted up.  Use of a bleaching agent / antioxidant can help with the pigmentation over time; however, treatment with chemical peels or lasers may be necessary.

New Orleans Dermatologic Surgeon
5.0 out of 5 stars 11 reviews

Tired looking eyes

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 Botox can be used to lift our eyes.  Your eyes are well lifted so Botox would not help.
Tired appearance mostly due to skin pigmentation and loss of volume. 

 Recommend :

a. a good skin lightening cream to lighten under eye area

b.  good eye cream to gradually fill in the volume, the baby fat that are normally lost 
   as we age.  

c. Filler to fill in the volume in the region. 

Under eye lines and sunk in look

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Thanks for your question and photo.  Botox alone may not be the answer.  It looks by the photos that you may need some under eye filler and skin lightening.  Please see an experienced injector for a complete evaluation and treatment.  You will love the results.  Thanks again, best!!

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

Improving the contour of the under eyes

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Botox works extremely well for those lines that occur during your facial expressions - such as frowning, smiling, and raising your eyebrows.  For the depressed areas under your eyes the most effective treatment will be a filler (Belotero or Restylane are good choices for this area).  This will improve the contour of your lower lid-cheek transition and make it appear less "sunken".  

Donald B. Yoo, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 64 reviews

Botox for under eye lines, hyperpigmentation and sag?

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Thank you for sharing your concerns. The problems that bother you cannot be corrected with Botox. Botox can help crow's feet at the side of your eyes and the frown lines between your eyes. Dermal fillers can help with the hollowed appearance of the lower eyelids. Hydroquinone 4% cream can improve dark eyelid skin. See an experienced eyelid surgeon to discuss options. 

Sunken eyes

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Unfortunately, Botox only works on muscles. Therefore, it will address those types of lines caused by overuse and chronic motion of the muscles of the forehead brow and crows feet area. The lines you are describing, the hollowness, and especially the discoloration, will not be affected by Botox. For the sunken look, I would recommend judicious filler such as Restylane placed into that area only by a very expert injector. This area is unforgiving to novice injectors. The fine lines directly below the eye, as opposed to the side of the eyes, can be treated with some kind of peel, such as a chemical peel or laser peel. Finally, there is no great solution for the blue/purple discoloration that is so common under the eyes. There are many skin creams which can help lighten this or obscure this, but to the best of my knowledge there is no one miracle cure for the vascular discoloration you're describing. If some of that darkness is caused by shadowing from the hollowness, that can be improved from the filler.
I hope this helps!
Best of Luck!
Dr. Subbio

Christian Subbio, MD
Philadelphia Plastic Surgeon
5.0 out of 5 stars 74 reviews

Eye issue

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Botox is really for lines of animation more commonly used for the upper 1/3 of the face.  Fillers can treats sunken areas of volume loss.

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

Sunken Eyes and Best Treatment

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Botox will help treat the wrinkles around the eyes and forehead but cannot replace lost volume.  The best treatments for lost volume are fillers such as Restylane, Belotero, or Juvederm. The key to volume replacement is to consult a board certified dermatologist who is a specialist in this delicate procedure.  Best, Dr. Green

Lower lids

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A good option for under eye "hollows" is hyaluronic acid filler injection. These injections are minimally invasive and very safe and effective to help volumize the hollowing in this area.
I would avoid Botox for the indication you describe. Be sure to see an oculofacial specialist or an injector with considerable experience in treating this area.

Kenneth E. Morgenstern, MD
Philadelphia Oculoplastic Surgeon
5.0 out of 5 stars 3 reviews

Botox and fillers to rejuvenate

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Altogether, the aging process of the face is often related to volume loss, as well as bone loss and fat loss. We get excellent results rejuvenating and recontouring the face with injectable fillers in combination with Botox, Dysport or Xeomin. In most women, we place a little filler in the mid face and cheeks to "lift" then we ad volume to the jawline to maintain facial harmony and create a natural, smooth appearance.In addition, I like to make sure that all patients are on a skin care regimen that includes sun protection in order to maintain a healthy glow and a tight skin tone to prevent further appearance of aging. Because all of these treatments are nonsurgical and largely preventative, it is important to seek out an expert who is board certified and specializes in injectables and minimally invasive treatments

Joseph A. Eviatar, MD, FACS
New York Oculoplastic Surgeon
4.7 out of 5 stars 68 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.