A divot appeared under my eye after Botox. It's been 4 days. Will it go away in the next few days? (photos)

Question

I had a PRP treatment (and a small amount of Botox to address creping under my eyes). I had severe black eyes and swelling after. As the swelling went down the wrinkling under my eyes got worse. I went back after a few weeks and received more Botox. It's been 4 days. the wrinkling is different but not gone. Most concerning is a new divot under my eye. I'm hoping this will relax since it takes up to 2 weeks for the full effect. I've had Botox before and have never had this reaction. Thoughts?

Andrew Campbell, MD · Answer

Your lower eyelids look a little swollen to me. More than likely, the swelling still hasn't resolved after your prior treatment. I'd recommend patience. Discuss your concerns with your provider. There are other treatments that help. Consider seeing a specialist.Andrew Campbell, M.D.

Facial Rejuvenation Specialist

Quintessa Aesthetic Centers

Facial Rejuvenation Specialist

Quintessa Aesthetic Centers

Jason Emer, MD · Answer

It's difficult to tell from your photos. Final results with Botox can take 1-2 weeks, however with under eye wrinkles, I recommend a combination approach for best results. Fillers, lasers, microneedling/PRP can help this area. I suggest you see an expert in facial sculpting.  Best, Dr. Emer.

Mahalingam Satchi, MD · Answer

The chances most likely are that this would revert back to where it should be but this may take more than 2 weeks to get back to normal.

Steven F. Weiner, MD · Answer

This is an area of volume loss that was made worse with excessive Botox. You wrinkles won't improve entirely with Botox. Volume is needed in the undereye and lateral orbital area. The skin in thin there and needs to be thicker. Collagen build up can be obtained using RF, such as Infini or laser resurfacing. I believe that PRP is overpromised by most caregivers as to what it can do. Also, you must know what concentration of PRP you are getting, because most is worthless as well. It must be 6x to be most effective.

Alex Eshaghian, MD, PhD · Answer

Thank you for
your question Essani. I am sorry to hear about your situation. Botox is
a purified protein used to address wrinkles associated with facial expression such as the crows feet seen around the eyes when one smiles. One change that is seen with age is volume loss under the eye. The fat pad descends from the tear trough area to the upper cheek. Normally the fat pad holds up the upper cheek, but when it descends the muscle under the eye acts as a ligament to hold the cheek up. If this muscle is relaxed with Botox the support is released and descent of the structures is seen. This can be addressed by placing fillers such as Restylane in the tear trough area. Please consult with
a doctor for specific recommendations. Good luck!

A divot appeared under my eye after Botox. It's been 4 days. Will it go away in the next few days? (photos)

Answers (5)