Under eye bags after Botox. I've already learned that Botox can cause under eye bags from the muscles not working properly.

Question

It's been about 2 months after my Dysport treatment, and I still have bags. In the daylight they age me good 5-10 years! I also still have some lines that form on the upper cheekbones. That means that even with the injections I don't get perfectly smooth skin around my eyes, and yet on top of that I get these horrible under eye bags. I am 45. Is there a solution, or do I have to choose between wrinkles and bags?

Jason Emer, MD · Answer

This is difficult to answer without pictures. From your description, a combination approach would give the most improvement: Botox combined with fillers, microneedling/prp, and lasers. I recommend getting a formal evaluation with a cosmetic dermatologist. Best, Dr. Emer

Aldo Guerra, MD · Answer

Bags under the eyes are a complicated anatomical problem that develops with age. Therefore, it needs a multi-modal approach. Neuromodulators like Dysport and Botox are only part of the solution in other words. I suggest have a full evaluation and consider other modalities like chemical peels, dermal fillers, lasers, and/or radiofrequency.The best results are achieved using multiple approaches. Best wishes, Dr. ALDO :)

Harold J. Kaplan, MD · Answer

Hi B&S. You don't have to choose between the two because there are other options for wrinkles including laser resurfacing and surgery.  Photos would help so if you post a follow up with photos, we would be better able to make recommendations to address your concerns.

Kenneth D. Steinsapir, MD · Answer

Many, many folks are injecting botox.  Unfortunately some are much better at than others.  A slumped lower eyelid and a bag in the cheek can result from weakening the lower eyelid inappropriately.  The problem will get better but it can last 6 month or more.  I occasionally use fillers to help folks with this type of issue but often the filler service then needs to be adjusted once the botox effect is resolve.  Seek a second opinion if you are truly frustrated by this issue.

Hardik Soni, MD · Answer

Thank you for your
question. This is most likely caused by poor injection placement. Having a slumped lower eyelid and a bag in the cheek
can result from weakening the lower eyelid. This should get better as the Botox
wears off in 3-4 months. I recommend having this evaluated by an expert to
determine if anything can be done to resolve this issue. Best of Luck!

F. Victor Rueckl, MD (in memoriam) · Answer

Would you mind posting photos? When I have seen bags appear it is more likely due to poor injection placement than anything else. Photos may help us evaluate you better. "This answer has been solicited without seeing this patient and cannotbe held as true medical advice, but only opinion. Seek in-person treatment with a trained medical professional for appropriate care."

Under eye bags after Botox. I've already learned that Botox can cause under eye bags from the muscles not working properly.

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