Are these bags under eye from Botox due to fluid retention or Botox causing fat pad to protrude more? (Photos)

Many patients attempt to hide the appearance of eye bags with fillers and this is often a satisfactory temporary solution. Ultimately, transconjunctival blepharoplasty with fat transfer or fat injections provides the best result for a more youthful rejuvenated appearance. Good luck

Hi there,This would just take time for the issue to resolve (approx 2-3months). the placement of the botox caused worsening under eye bags and sometimes because of the weakness of the eye muscle is causes fluid retention in the area of the fat pad. 

It is possible that weakening/paralysis of the portion of orbicularis occuli muscle due to Botox injection have created protrusion of intraorbital fat and worsened tear trough deformity. Once muscle regains its normal tone (2-3 months) deformity will  disappear. It appears that best long term option would be transconjuctival lower blepharoplasty with fat pads transposition. Good luck.

Thank you for sharing your question and posting your photographs. Injection of Botox beneath the eyes can cause the fullness you are seeing. Wait a few months for the Botox to wear off and follow the advice of an experienced, board-certified Oculoplastic Surgeon. It is usually a good idea to get a couple opinions from different doctors. Good luck,

The worsening of the bags under your eyes are likely due to the Botox that was given there. Things will go back to your pre-injection state once the Botox wears off in 2-4 months. I would not recommend doing Botox there again. Fillers and radiofrequency treatments may provide a temporary improvement, but ultimately surgery would be needed to give you the best result. Make sure you are under the care of an experienced physician provider. Best wishes.

This may be due to Botox placement. 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

Thank you for sharing your question and posting your photographs. Injection of Botox beneath the eyes can cause the fullness you are seeing. Wait a few months for the Botox to wear off and follow the advice of an experienced, board-certified Oculoplastic Surgeon. It is usually a good idea to get a couple opinions from different doctors

Hello Viv
I have been consulted for this same problem before. The area of concern is involved in lymphatic drainage, and after Botox, this can be slowed due to the loss of contraction of the orbicularis oculi muscle
Filler would give support and structure to the area and in future may be a better option for crows feet and to minimise infraorbital eye bags or hollowing. However, one must be cautious in injecting to avoid that malar fluid area, as the filler will aggravate this

Thank you for your question and for sharing your photographs vivbb. I understand your concern. Botox is a purified protein used to address wrinkles associated with facial expression. When injected into the skin Botox will relax the muscles and smoothen out the overlying wrinkles. The most common areas of treatment are in the upper face. These include the horizontal lines seen on the upper forehead when one raises the brows, the vertical lines seen between the brows when one frowns (frown lines), and the crow's feet seen around the eyes when one smiles.It is difficult to make an assessment in the absence of consistent photographs before and after in the same lighting and angles for comparison. However, I hope the information provided here is useful.The pivotal studies used 24 units of Botox (12 units per side) to address the crow’s feet. These studies demonstrated that the peak results are seen 14 days after the treatment and most people enjoy their results for 3-4 months. At that point, a maintenance treatment is recommended. While some people start to see results as early as the next day, it can take two weeks for full results so patience is important. We have our patients return two weeks after their treatment to assess their results via photographs. At that time additional units may be added if necessary.Some people have a deficit under the eyes due to loss of or downward movement of the fat pad in the tear trough area. In some cases, the muscle around the eyes serves to hold up the upper cheek fat pad. If this muscle is relaxed with Botox (as it is when addressing crow's feet), this volume deficit can be exaggerated. In these cases, restoring the lost volume with fillers such as Volbella or Vollure under the eyes or Voluma in the cheeks can correct the deficit.If I had a patient with the concern described here, I would say she is a good candidate for a filler treatment under the eyes once the swelling has resolved.With any injection, there are risks such as pain, bleeding, bruising, redness, swelling, tenderness, and infection. We take special precautions to minimize these risks such as using a painless technique. We also treat bruises with a laser as early as the next day. Bruises usually resolve within two weeks if untreated. After a laser treatment bruises usually resolve in 1-3 days, but may still take two weeks for full resolution. In addition to these risks, with Botox there is also a risk that the product spreads or diffuses to nearby structures. Spread to nearby muscles can lead to side effects such as the temporary appearance of droopy eyelids or a temporary asymmetric smile.

After a Botox treatment, I recommend that my patients avoid heat exposure, alcohol consumption, and strenuous exercise for 24 hours and not lie down flat for four hours. This is because all of these activities may possibly lead to the movement of the product and consequent side effects such as droopy eyelids. Although there have been no definitive studies shown that these actually occur and some physicians do not provide such aftercare instructions, in the absence of data I err on the side of caution and recommend that my patients avoid such activities.

Please consult with a doctor for specific recommendations. Good luck!

At this point you must ride it out. The lower lid in some patients can handle being weakened. The is some laxity in the lid and the lymphatic drainage is probably impaired. I would do surgery after the Botox fades. I don't think you will be happy with just filler.