I got Botox injected in my lower eyelids near the corners of my eyes. I now have puffy wrinkly bags? (Photo)

Sorry to hear about your experience. Botox injections around the eyes is common and can give a great esthetic look when injected properly. Without viewing a before and after photo it is difficult to determine the difference between before and after. Schedule an appointment with your injector and discuss your concerns. All the Best. 

Botox injections around the eyes can sometimes lead to
complications such as double vision and pseudoherniation of the infraorbital
fat pads.  Double vision is a rare
complication that occurs when the Botox diffuses to the extraocular muscles.  These muscles are responsible for eye
movements, and paralysis causes a condition called strabismus.  It is important to see a board-certified
ophthomologist as soon as possible so that an accurate diagnosis can be
made.Strabismus is usually temporary,
and temporary treatments can help with symptoms until the extraocular muscles
regain normal function.  An
ophthalmologist may recommend an eye patch or a Frensel membrane prism in your
eyeglasses, and you will need to be seen on a regular basis to monitor for
resolution of the condition.The bags that you notice under your eyes may be
a result of pseudoherniation of the infraorbital fat pads.  Botox injections to the lower eyelids will
weaken the orbicularis oculi muscle.When this weakening effect occurs in patients who have increased laxity
of the orbital septum, the relaxation of the support can cause temporary
herniation of the infraorbital fat pad.  This problem usually resolves as the orbicularis oculi muscle regains
function.  It is important that you see a
board-certified facial plastic surgeon to discuss these problems and to reduce
your risk of complications in the future.

We don't have any before and after photos to evaluate so the responses cannot be made relevant to your condition. Also, I'm assuming that the injection was in the medial corner of the eye and not the lateral but you didn't specify. Injecting 1-2 units in an extremely superficial layer (bleb) in the mid-pupilary line of the lower lid, can cause a pleasing rounding of the eye and soften the hyper dynamic orbicular is muscle with facial grimacing or smiling. However, I'm not sure as to indication for injecting medial to this line. If its injected deep (which is very easy todo) or if you rubbed your eyes or even blinked hard right after the injection, the muscles responsible for the movement of the globe may be temporarily weakened and giving you the sensation of swelling of lower lid and frozen eye. It will dissipate over the next 4-6 weeks. In the mean time protect your eyes from bright light and dryness.

So what is your question???I do not believe the lower lids became swollen from the BOTOX. What has happened is the smoothing effect on the lateral lids revealed the wrinkles and swelling of the lower lids... 

Thanks for your question and photograph post.  Injecting Botox medial to the mid pupillary line can be tricky.  It can disturb your blink reflex and can even affect the muscles that move your eyeball.  Depending upon how much was injected it could wear off in 2 to 6 weeks.  There is not much you can do but wait.  

Dear Erin White,

The
injection of Botox® affects the muscles of facial animation. There are many animation muscles around the
eyes. From your clinical history, it may
be that the Botox® has weakened the specific eye muscles that are able to
squeeze fluid out from under the eyelid.
When these are relaxed, the circular muscle around the eye that acts as
a sphincter, or a pump, for lymphatic fluid in some patients gets weakened and
although passive wrinkles may be improved, there are “puffy bags” that can
occur under the eye towards the outer corner and even under the inner eye
towards the corner.

You
are absolutely right. In general, the
treatment for these puffy bags would be injection of very, very dilute
anti-inflammatory products such as Kenalog and physical manipulation, using
facial lymphatic drainage techniques and bulk heating radiofrequency current
devices, such as Accent®, Forma®, TriPollar™ and other bulk heating devices.

More
concerning would be that you have apparent history of visual changes when
outside and you feel dizzy. It is
extremely important you visit your certified physician Botox® injector to
ensure there was no weakness of the muscles that actually move your eye. Weakness of these muscles may lead to double
vision, blurriness and result in a sense of dizziness, as you’ve
experienced.

I am
sure that your certified physician injector will be able to treat and reassure
you as to the post-Botox® injection concerns.
Even the best and most experienced injectors in the province can
encounter periocular eye complications such as you have experienced. I’ve been performing Botox® injections for
the better part of 20 years and periocular sensitivities and temporary
aesthetic complications, such as you described, can occur.

It is
important that you have a physician with knowledge in treating these concerns,
as many of your symptoms can be improved without having to wait for the Botox®
to wear off.

Hope this helps, best of luck.

Sincerely,

R. Stephen Mulholland, M.D.,
Certified Plastic Surgeon, Yorkville, Toronto