Not the results I wanted. Xeomin for tear troughs, lines...fillers

I had xeomin 4 days ago for wrinkles around forehead however i was very clear that i was very unhappy with the under my eyes.I am seeing improvement (great improvement) with wrinkles but minor improvement with eye circles (tear trough). I go back to doctor in 5 days for "touch ups". If i do not see the improvement under the eyes that i was very clear about my main concern and am told i need fillers to correct so i have to pay again. I loved the doctor and i know she was conservative.

Doctor Answers 10


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It will take 2 weeks for the full effect of your treatment to be seen. However, Xeomin will likely have no effect on tear troughs. Fillers are indicated for that region..


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Thank you for your question in regards to Xeomin. It is best to have a follow up appointment with possible touch up two weeks after initial injection. This way, Xeomin has time for complete correction. To be sure, see two or more board-certified providers in your area for a complete evaluation to make sure you are a good candidate and that it is safe for you to have treatment. I hope this helps.

J. Jason Wendel, MD, FACS
Nashville Plastic Surgeon
5.0 out of 5 stars 221 reviews

2 separate problems

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Thanks for posting. You have 2 separate things going on from the sound of it. First, you have dynamic lines (lines of the forehead and crows feet) These are lines caused by movement of the underlying muscle. These were appropriately treated with Xeomin and should do well. For under the eye, or tear trough area, it sounds like you need volume (ie fillers). If the volume is replaced and the skin still seems lax or wrinkled consider laser treatments. Be well, Dr. M

Jared Mallalieu, DO
Annapolis General Surgeon
5.0 out of 5 stars 8 reviews

Inappropriate use of XEOMIN®

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XEOMIN® is not FDA approved for use on the lower eyelids.  It is not surprising that did not get the result you desired. 

Filler for under the eyes in tear trough

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I would have to see your face in order to see what suits your needs best.  However from what your explaining fillers would be best for the under eye area.

Z. Paul Lorenc, MD
Manhattan Plastic Surgeon
4.6 out of 5 stars 34 reviews

Filler for under the eyes in the tear trough

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Thank you for your question. I think filler is the better option for the inner lower eye. It will help to fill the area. Best of luck!!

Xeomin and Fillers

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I am unsure the exact question.  5 days isnt enough to see the results of xeomin, you should wait 10-14 days for treatment.  As for the under eyes, fillers should be done conservatively there and if more is needed then please speak to your physician.  Cannula injections limit complications.  Best, Dr. Emer.

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.8 out of 5 stars 207 reviews

#Botox #Xeomin - Xeomin for tear troughs, lines...fillers

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I'm glad you liked your doctor - but I'm not sure you got accurate information! 

While there are no absolutes, my general preference is to treat areas at and above the level of the eyes with neurotoxins, such as Botox and Xeomin.  If desired, treatment of the tear troughs and any other hollows, or where additional volume is the goal, you'll need a filler.  For the tear troughs, that would normally be a HA (hyaluronic acid) such as Juvederm, Restylane, Belotero, etc.

When you go back...have a calm discussion with your doctor and explain (again) what you'd like done, and then go over the pluses and minuses of each possible treatment, before even getting to the cost.  There may a very good and simple reason why your doctor made those recommendations.

I hope that this helps and good luck,

Dr. Alan Engler
Member of #RealSelf100

Xeomin and Tear troughs

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I am sorry you are not happy with your treatment.  It sounds like the Xeomin was effective on the forehead, but did not effect the tear troughs.  This is not surprising since Xeomin does not address that problem!  In my practice, we inject Belotero into the tear troughs.  This is a separate procedure with additional material, so I would expect your doctor to charge you.  

Harry Goldin, MD
Skokie Dermatologist

Treatment for tear trough

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Glad you had good results on the forehead for lines as this is what Xeomin is indicated for.  Tear trough will not respond to any botulinum toxin.  Since it is a concave area, it needs to be filled with filler

Melvin Elson, MD
Nashville Dermatologist
5.0 out of 5 stars 7 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.