Intense creases/folds under my eyes after Botox - Any ideas of what I should do to fix this? (photos)

Thank you for your question. It is unlikely the lines you are seeing are linked to Botox or hyaluronic acid. You may be a good candidate for a non-surgical liquid eyelift that utilizes facial fillers such as Restylane or Sculptra. These fillers can reduce the appearance of lines and creases under the eyes by adding subtle volume, and can often be administered alongside ongoing Botox Cosmetic treatments to maximize results. I recommend that you schedule an in-person consultation with an accomplished, board-certified facial plastic surgeon. They may be able to better assess your newly formed lines and help you decide on the best treatment plan to alleviate your concerns.

Thank you for your question and pictures! Horizontal eyelid wrinkles and sagginess can be corrected with blepharoplasty or cosmetic eyelid surgery. It is one of the first cosmetic surgeries people usually get. While the average age might be 30 to 50's, some patients get this done in their 20s. It really depends on your unique anatomy as well as what exactly is bothering you. It is unclear if your pictures are before and after, but I do not believe moisturizer caused this issue. It is best that you consult your physician and have the area properly assessed.

Botox injections as well as laser treatments can also be a tremendous benefit if you are not interested in surgery. Of course, there are also many combinations.

A mini facelift or midface lift is another great option for many people to correct malar bags and other signs of aging around the eyelids. The recovery & downtime is very minimal. There are usually no drains, most people can go out the same day, you can shower the next day, there are no scars behind the ears, and you can wear your hair up anytime and most patients take no pain medicine. There are never any guarantees of course with any procedure whether it is surgical or nonsurgical in nature.

I would recommend that you see a board-certified plastic surgeon in your area that is a member of both ASPS & ASAPS and performs a lot of eyelid lifts but also offers all the nonsurgical options such as injectables and laser treatments. Go over your concerns with them and make sure above all, you walk out of there with several options and an idea of the pros and cons to each of them as well as realistic expectations.

It is difficult to tell the cause of your problem without really examing your face and watching an animated motion. but it is unlikely from botulinum injection because if anything botulinum toxin freezes muscle and removes wrinkles, and all available brands of botulinum toxins usually only work for 2 to 3 months with each injection.

At home peels like cosmelan, enlighten and aerify along with dermarolling (MTS roller with anteage MD ampules) should be started now. There are many things you can do to treat under eye hollows and dark circles. A surgical option to remove skin and/or fat will such as lower eyelid blepharoplasty with or without fat pad repositioning will be the best long term. There are many things you can do to treat under eye hollows and dark circles without surgery. Non invasive less downtime options such as fillers (Belotero, Juvederm Volbella​), lasers (Moxi/Halo/Fraxel/CO2​), Renuvion (J-Plasma), microneedling/PRP, stem cells and microneedling RF like Fractora PiXel8 or Morpheus can all help give some improvement. Accutite can often be used or stronger lasers like erbium or co2 spot treatment can tighten the skin and give very quick improvement in wrinkles and texture. A surgical option to remove skin and/or fat might be the best solution long-term. I suggest you get a formal consultation to see what is best for you and your goals. Best, Dr. Emer.

It's important that your injector knows where to inject for crow's feet. If the treatment isn't done correctly it can result in a "shelf" below the eye. This will resolve as the product is metabolized. Always see an expert injector for treatment.

Every individual reacts differently to botox and sometimes, a clients response to botox treatment to the crows feet area will trigger surrounding muscles to over compensate. You can ask your provider to relax the under eye area with a little botox or you can just wait for the botox to wear off in about 4 months. Once the botox wears off, you will no longer be "over compensating" at the undereye area and those "new" wrinkles should soften as well.

The muscle that causes crow's feet is a big circle around the eye. Sometimes when this muscle is only injected around the sides of your eyes, and not much underneath, the fibers of the muscle under your eye start to overcompensate for the parts that are frozen. This can pull wrinkles that didn't used to be there. I'm not sure why you're stinging with the aloe vera - that is not a side effect of Botox. Perhaps you're sensitive to the hyaluronic acid moisturizer and your skin is irritated.