Swelling & black under eye 1 month after Botox. What should I do? (photos)

Question

I was injected on right side if my eye which caused a major black eye. Now 1 month later still very puffy under eye? Help!!!

Jerome Edelstein, MD · Answer

Please return to your injector for an assessment of your concern. This appears to be unusual and should be checked out. All the best.

Michael A. Persky, MD · Answer

Hi Susan,Sorry to hear about your bad experience post-Botox treatment.  You should contact your treating physician for examination and treatment.  We have recently been using electro-magnetic and radio frequency 5 to 10 minute treatments with excellent resolution of bruising and swelling after injection treatments.  Good luck and be well.Dr. PEncino, CA

Evan Ransom, MD, FACS · Answer

The other experts here have highlighted some important points. To review, 1) Botox injections should be limited to the area lateral to the eye (the 'crow's feet), to avoid issues with lower eyelid swelling and impaired function.  In my practice, I never inject Botox more toward the middle than the outer edge of the colored part of the eye.  2) Soft tissue fillers are a better choice for treatment of hollowness in the under eye region in many patients; others require eyelid lift surgery for the best aesthetic results.  3) Topical arnica montana gel is helpful for bruising in the first week after injectable treatments; later than this, it is not particularly effective.  4) Persistent bruising can be treated with specific lasers to help the body absorb the stain from the blood beneath the skin.  Best of luck moving forward!

Jason Emer, MD · Answer

Botox if used under the eye should be injected in very small amounts and in the right candidates.  You don't appear to be a candidate for this type of treatment and it likely was not injected correctly.  I have never seen a bruise that deep or severe from Botox, ever.  Like said on other comments, fillers and/or laser is better for the undereye wrinkles.  Please seek the advice of a cosmetic dermatologist or plastic surgeon with much experience in utilizing toxins, fillers and lasers for various skin dilemmas.

Harold J. Kaplan, MD · Answer

Hi Susan.  It does not look like swelling to us. If the under eye area was injected with Botox, then it's very likely that you have a relaxation of the muscle that surrounds the eye.  This relaxation gives you the appearance of being swollen.   The bottom line is that Botox is not a good product under the eyes and should not be used there.  We much prefer laser resurfacing or Restylane to address lines or volume loss in the same area.  The good news is that the effects should wear off soon, usually within a month or so.  Good luck.

Michele S. Green, MD · Answer

You have considerable swelling one month after Botox and it is unclear to me where the physician placed your Botox.  I personally have not seen this type of swelling from Botox. Did you receive any other filler in that area? I would return to your treating physician to assess the situation.  Please let me know what happens.

Charles A. Wallace, MD · Answer

In your particular case, it looks as if the Botox was not properly injected in the standard area recommended.  I always suggest Arnica Montana, which is a homeopathic for swelling and bruising, especially in my patients who are prone to bruising.  I have them take it one week before injecting Botox or facial fillers.  Always ask for an ice pack which helps constrict the blood vessels.  I would suggest that you always have Botox performed by a licensed physician and preferably a Board Certified Plastic Surgeon.

Swelling & black under eye 1 month after Botox. What should I do? (photos)

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