I Had Undereye Botox 5 Months Ago and Still Have Have Horrendous Fat Pouches Under my Eyes.

Botulinum Toxin (Botox and Dysport) injections can make EXISTING lower eyelid fat bags or pouches appear to be worse but it is not known to make them appear de novo. The lower eyelid muscle tends to hold the fat back around your eye the same way your abdominal muscles hold back your intra-abdominal fat. And in the same way you can make stomach bulge by relaxing your stomach muscles, your lower eyelid fat can bulge out when the muscle relaxes. Tho opposite occurs when you squint - it tightens your eyelid muscle and pushes back the fat pads.   

The fat bags you complain about are probably not from your Botox injection, since it would all be worn off by 5 months. You definitely need another opinion about what had happened and hopefully the dermatologist you see can help. It may also be helpful to the dermatologist for you to get a copy of your records from the doctor who initially treated you.

If Botox were the only thing injected in the lower eyelids, and if you had a tendency to retain fluid in your lower eyelid bags, then the Botox might interfer with the muscular pumping action of the eyelid and the fluid could accumulate more. In general, though, the Botox effect would not last more than five, to six months tops and the fluid situation would be expected to improve. Was there more than one needle prick youfelt in each lower eyelid? Possibly a filler was injected. Ask your doctor who had performed the treatment.

botox wears off in 3-4 months and doesn't cause fat pad bulging in the first place.  Is it possible that you had a filler placed under your eyes?  Wishing you the best.

From your description, it sounds like the issue is fat pads which would not have been significantly improved by Botox, and the Botox effect is likely gone by now anyway. There are a number of possible solutions, about which we can only speculate without seeing you personally. Sometimes injection of a filler such as Restylane or Juvederm just below the eye bag, to fill in the area where a shadow is seen, can be a good nonsurgical fix. You may also benefit from a surgical blepharoplasty, in which the fat pads would be repositioned for the same effect.