Question about "roll" under eyes (Photo)

Question

I had Botox under my eyes to treat crowsfeet. Instead of multiple fine lines I have big creases under my eye which looks like a "roll" when I laugh. What is this?

Camille Cash, MD · Answer

When injecting for crow's feet it is important that the injector knows where to inject or the result can be this "shelf" under the eye.  This is temporary and will return to your pre-treatment look as the product effects wear off.  Always visit with an expert injector for your Botox treatment.

Jason Emer, MD · Answer

The eye area needs significant combinations to get improvement. Lasers like erbium, co2, halo, profractional/contour, or Fraxel can all be used to build collagen long term. Plasma pen is a newer less invasive option but will take many treatments and require proper skincare. Plasma Pen is focused electrical plasma energy to tighten skin, producing small columns of energy just above the skin, allowing the skin to tighten to help improve wrinkles. This area will have 3-5 days of small “dots” that will then scab and peel, then the skin will tighter and brighter after. Numerous treatments are needed over lasers where only one or two give a bigger result, but more downtime. After plasma pen you NEED peels 2 weeks like later Cosmelan, enlighten or aerify, see emeragecosmetics (link). At home derma rolling should be started weekly even after plasma pen or lasers to further increase collagen, see emeragecosmetics AERIFY x anteagemd stem cell ampules. To properly heal you need light Stim red LED, EmerageSkin refit face, refit eye; AnteageMD serum, silagen silicone gel, jan Marini bioshield, EmerageSkin enzymatic polish, and EmerageSkin hyla b and AOX, and Sente dermal repair. Otherwise there is EXTREME risk of pigmentation issues and “dots” in the treatment area. at home peels like cosmelan, enlighten and aerify along with dermarolling (AERIFY emerageskin roller with Anteage MD ampules) should be started now regardless for antiaging, sun damage, and wrinkle prevention. 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 eyelid blepharoplasty with or without fat pad repositioning (if doing lower eyelid surgery) 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, lasers, microneedling/PRP, cosmelan peels, 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. I suggest you get a formal consultation to see what is best for you and your goals. Best, Dr. Emer.

Geeta Yadav, MD · Answer

Thank you for your question! This "roll" along the lower lid is created by the orbicularis oculi muscle contracting and bunching up when you make facial expressions. It’s possible that a Botox touchup may correct this, but it’s hard to tell without an in-person evaluation. Book an appointment with an experienced provider who can determine the best course of treatment for your individual anatomy and aesthetic goals. Hope this helps!

Chuma Chike-Obi, MD · Answer

The circular muscle around your eye (orbicularis oculi) has fibers in this area that bunch up, along with the underlying skin.
A tiny sprinkle of botox in this area can soften this, but it will not eliminate the issue.
Addressing the skin and/or the muscle is the definitive fix. Laser, blepharoplasty are two options that may be considered.

Samir Shureih, MD · Answer

The "big crease" you see under the eye in the lower lid is caused by a part of the orbicularis occuli muscle (pre-septal portion of the muscle) contracting as you smile.
Choose a Board Certified Plastic Surgeon as your injector as they understand the different portion of the muscle and their function.

Question about "roll" under eyes (Photo)

Answers (5)

Answer: Bunching of under-eye muscle and skin

Answer: Bunching of under-eye muscle and skin

Answer: Botox

Answer: Botox

Recommended reading

Everything you need to know about Botox

Our mission is to create a world where every investment in modern beauty is Worth It.

Question about "roll" under eyes (Photo)

Answers (5)

Answer: Bunching of under-eye muscle and skin

Answer: Bunching of under-eye muscle and skin

Answer: Botox

Answer: Botox

Browse related questions

Recommended reading

Everything you need to know about Botox

Our mission is to create a world where every investment in modern beauty is Worth It.