Why do I have a blue bump and crepey wrinkled skin under my eyes after Botox? (Photo)

Question

I had Botox two weeks ago around the eyes, and went in for a touch up last Thursday, January 10th. On Saturday, January 12th, I woke up with a puffy, blue bump, making me look like I had a black eye. It is now 5 days later and the blue bump has not gone away. When I smile, the bump pushes up into a bumpy wrinkle, and makes me have very crepey skin. Any idea why this would happen and have suggestions or advice? It looks horrible and I’m very upset....

Jason Emer, MD · Answer

Botox results last up to 3-4 months and can be softened with venus legacy and thermage treatments. I recommend getting a formal evaluation with a cosmetic dermatologist. Best, Dr. Emer

Harold J. Kaplan, MD · Answer

Hello RM.  Sorry to hear about your situation.  Botox injected under the eyes is very tricky.  When it does work well only tiny amounts can be used and it doesn’t last that long.  It appears that too much was injected.  When this is the case, the muscle around the eye weakens and that is what caused the puffy pouch below the right eye.  Rest assured this will resolve but the time frame depends on how much was injected.  For future reference, dermal fillers, surgery and/or laser resurfacing are much better options to improve the appearance of the area under the eyes.  Botox is rarely a good option and results are limited.

Susan Longar, MD · Answer

Thank you for your question!  Unfortunately, it is likely the botox that caused your situation.  When the muscle under the eyelid is weakened, this type of "pooch" can occur.  In time, it will wear off and you should return to your pre-botox appearance.  I hope you returned to your injector to show him/her, they should know about your unpleasant outcome.

Amy Y. Paul, DO, FAAD · Answer

That's very unfortunate!  It will eventually wear off, but it appears your fat pad has become visible under the right eye due to lack of support from the orbital muscles.  We don't traditionally inject directly under the eye - the muscular movement in the lower eyelid is important to allow you to close your eyes properly and protect the eyes, and you would not want to have any safety risks in that delicate area.  Be careful when getting injections and make sure the injector is a board certified physician in one of the core cosmetic specialties such as dermatology or plastic surgery.  Best of luck!

Monika Soni, MD · Answer

Thank you for your question! Sorry to hear about your situation.  Botox injected under the eyes is very tricky.  When it does work well only tiny amounts can be used and it doesn’t last that long.  It appears that too much was injected.  When this is the case, the muscle around the eye weakens and that is what caused the puffy pouch below the right eye.  Rest assured this will resolve but the time frame depends on how much was injected. For future reference, dermal fillers, surgery and/or laser resurfacing are much better options to improve the appearance of the area under the eyes.  Botox is rarely a good option and results are limited.

Christopher R. Macdonald, FRCS(Plast) · Answer

When the muscle under the eye (and around the eye) is weakened by either too much BOTOX or misplaced BOTOX the fat pad can push forwards and give a puffy look. It looks like this is what has happened to your right eye.
I would suggest discussing this with your injector but it is most likely that you will have to wait for it to settle on its own with a bit of time.
Good luck.
Dr Chris Macdonald
CRM Aesthetics

Leonard Grossman, MD · Answer

If any amount of Botox was injected into the lower eyelid muscles, a bag of your own fat will pop out since the muscle becomes weaker and cannot hold this orbital fat in place. It may also be that you have a small amount of swelling that is secondary to the trauma of the needle piercing the skin. Both conditions will improve with time. Good luck from New York City

Melvin Elson, MD · Answer

It is difficult to tell from the photos but a blue bump usually means a bruise which will go away on its own but to speed its demise apply warm compresses and apply vitamin K cream

Devrim Elmas, MD · Answer

Patients notice other concerns easier after neurotoxin injections. It's right time to make some under eye procedures. Could be good to see your photo before the procedure.
Try to find a doctor who understands your needs and whose esthetic vision fits yours.
"This answer has been solicited without seeing this patient and cannot be held as true medical advice, but only opinion. Seek in-person treatment with a trained medical professional for appropriate care."
Good Luck.
Dr. Devrim Elmas, MD
Medical Esthetic Doctor
IG: @drdevrimelmas

Why do I have a blue bump and crepey wrinkled skin under my eyes after Botox? (Photo)

Answers (9)

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