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.

Dear Fed up

Not much of a BOTOX treatment is left at 5 months.  It is therefore improbable that your issues are related to BOTOX.  It is more likely that BOTOX weakened the muscles overlying fullness in the lower eyelid, did not help your cosmetic concern and now that your BOTOX has worn off, you are aesthetically unimproved and worse off by 5 months.  It is important that you find other qualified help as it is clear that your don't have confidence in your prior injector.  Consider posting your images. 

I doubt the Botox is causing your symptoms.  Botox last about 3 months anyway, so the effect should be gone by now.  I recommend a consulation with an oculoplastic surgeon in order to examine your eyelids and determine what options there are.  I cannot comment further without your photograph.

Dr Taban

Regarding: "I Had Undereye Botox 5 Months Ago and Still Have Have Horrendous Fat Pouches Under my Eyes.
I have returned to the cosmetic surgeon twice and he said that it would go in time. I look like I have two black eyes, minus the bruising! I went to two other surgeons and one said wait it out and the other questioned whether filler had been used instead of Botox! I am devastated. I have an appointment with a dermotogist this week to see if Laser might work. At the moment I don't feel like this is ever going to go away. Should I steer clear of Botox forever?

I am assuming the ?doctor who injected you indeed used Botox and not a filler. Although WHY would any Plastic surgeon or Dermatologist who has even a basic understanding of botox inject it in the lower lid ("under the eye") makes no sense.

Botox weakens / relaxes muscles. Since the thin muscle around the eye, the orbicularis oculi muscle, barely keeps the fat around the eye within the eye socket, it makes NO sense to weaken it in a foolish attempt of smoothing wrinkles of the central lower lid. Doing so will almost always result in intraorbital fat pooching out causing worsening bagginess of the lower lids and a much more aged look.

 I would not steer away from Botox forever but I think you should steer away from inexperienced Botox injectors forever and a day.

Dr. Peter Aldea

In general, I'd recommend placing botox in the crows feet area only.  Other areas around the eye like under the eye can cause some problems.  It's impossible to recommend what treatment would be best for your eye area without seeing you in person.  In general I'd recommend going to a board certified plastic surgeon, facial plastic surgeon, or oculoplastic surgeon experienced in the eye are to give you the safest and most accurate advice.

Dr. Cat Begovic M.D.

It is actually quite common in older patients wanting to get rid of the lines under the eye and the doctor injected too medial into the muscle around eyes. The protruding of the fat does not go away after BOTOX wears off especially if you are older. You option now would be lower eyelid surgery to remove the fat pocket. Laser may help temporarily but you will be much better off with lower lid surgery.