One week after Botox, when I smile the skin under my eye is bunching up, giving me a hollow and very wrinkled look. (Photo)

He did 15 on each eye. I noticed the results by the end of the day. I went back to the dr and they said to wait and worst case they could do some fillers. Fillers helped me look less tired but still have the hollow wrinkles under my eyes. I have read that botox under the eyes is dangerous so as of now I am just going to wait it out in hopes that my face will look normal here soon. But going forward, am I doomed to never have botox again?

Doctor Answers 8

Botox causing hollowing of eye


Thank you for your question and for posting pictures.

The bottom line is to have less Botox injected to reduce the likelihood of this happening in the future.

Best
Dr Karamanoukian

One week afterBoto, when I smile the skin under my eye is bunching up, giving me a hollow and very wrinkled look.

Thank you for your question. This does happen to a small percentage of patients. Botox under the eye is not dangerous, it is off label and requires a expert injector to assess the area. That being said, it will not correct the entire concern. A small amount of filler under the eye may help, an in person assessment is always best. 

Best, 

Martin Jugenburg, MD
Toronto Plastic Surgeon
4.9 out of 5 stars 427 reviews

Botox bunching under eyes

this is very common and can be improved with lasers and microneedling. I suggest you see a cosmetic dermatologist with experience.  Best, Dr. Emer.

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.9 out of 5 stars 168 reviews

Worsening of Lower lid wrinkles after Botox for Crow's feet: A possiblity

Hello! Following Botox for crow's feet, it is possible that the lower eyelid wrinkles appear in excess in comparison. This could be due to the 'spillage' of innervation impulses that were actually supposed to act on the muscle that is relaxed. It therefore ends up contracting the untouched lower lid muscle, leading to the increased wrinkling. In most cases, this should soften and resolve in a few days.

There is no way a doctor can predict this before hand, especially if this is your first injection. That is why, it takes two to three sessions for a doctor to realize what sites and dose is best suited for an individual's anatomy. You could very well have Botox again, but may be less units, and also a unit or two into the lower lid as a 'feathering effect'.

Milind Naik, MD
India Ophthalmologist
5.0 out of 5 stars 1 review

Botox and under eye wrinkles

 Thank you for your question and for sharing your photos and experience with us.  It is likely that by softening the crows feet muscles, when you try to smile, the unaffected muscles of the inoculates muscles underneath the eyes is more active than usual. Placing one or two units of Botox under this area can help soften this region. I would make sure that your injector it is well-versed in the anatomy of this region.

Wrinkles Under Eyes Worse After Botox?

I have certainly heard this question before, and it is typically just a matter of time, as well as gaining an understanding of how the muscles work. The Botox treatment itself should not have caused more hollowing than you had previously, however the wrinkles under your eyes may seem more pronounced post-treatment. The most likely reason is the muscles under your eyes are now “picking up the slack,” meaning when you make a facial expression, the untreated muscles are contracting more to compensate for those around the eyes that are now inactive.

The good news is that the effects of Botox will typically taper off and soften within the first couple of weeks, especially if this is your first treatment. Give the Botox another week or so; at that point the “bunching” you are describing may not be as severe. If after two weeks you do not notice an improvement, follow up with your physician. You should still be a fine candidate for re-treatment in 3-4 months, however you may want to have less units injected in order to avoid what you are currently experiencing. Best of luck!

Nissan Pilest, MD
Irvine Dermatologic Surgeon
4.7 out of 5 stars 17 reviews

Botox around the Eyes

Botox is a fabulous injection for the wrinkles around the eyes.  It is possible that they injected too low and that is why you don't like the effect.  Best, Dr. Green

Botox and under eye wrinkles

Botox is a great solution for crows feet an lines around the eyes.   In patients who have a prominent bulging of the lower lid when smiling, Botox can help to soften and flatten this area if used in small amounts.  When treating the crows feet, it is important to consider the effect on the surrounding tissue.  If too much is used, a complete paralysis may cause recruitment of other muscles when smiling creating new lines.  This will wear off slowly, but consider a small amount of botox directly below the eye.   Fillers can hep mask the volume loss and hollowness below the eye.  Make sure to seek out an expert injector for these treatments.

Kyle Coleman, MD
New Orleans Dermatologic Surgeon
5.0 out of 5 stars 8 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.