Loose and dropped skin under eyes, worse after botox under lower eyelids? Almost looks like I need a lift? (photo)

Question

Hi, I have loose puffy, squelchy skin under and to the side of eyes above check bones, seems to have happened after botox, had it placed under the eyelids too. Looks like the face under and around the eyes has dropped a centimeter or so. Any ideas if this will correct, notice due to wear off soon? Right eye worse than left.

Mark Glasgold, MD, FACS · Answer

this is a result of the botox treatment and will resolve with time - probably will start to improve within 6 - 8 weeks of the treatment
better not to do any other treatments in the meantime as they have minimal chance of having a positive effect, may make it worse and will only complicate the situation going forward

Jason Emer, MD · Answer

This could be due to Botox treatments. Botox results last for 3-4 months. In the mean time, venus legacy and thermage treatments may give improvement. See an expert. Best, Dr. Emer

Alex Eshaghian, MD, PhD · Answer

Thank you for your question coolhandlucast. I understand your concern. Botox is a purified protein used to address wrinkles associated with
facial expression. When placed around the eyes Botox can address crow's feet, the wrinkles that are seen around the eyes when one smiles. In some people the muscle that is being relaxed in this treatment is used to keep up the fat pad in the upper cheek. If relaxed the fat pad descends and can lead to hollowing under the eyes. The effects wear off in 3-4 months. Fillers can also be placed in the tear trough to restore the lost volume. Please consult with a doctor for specific recommendations. Good luck!

Rebecca Gelber, MD · Answer

So sorry to hear this happened to you. It sounds and looks like it is likely due to the Botox placement. In that case it should wear off in 3-4 months. Be sure to seek out a very experienced injector  - injections around the eye can be very beneficial, but only for the right patient and in correct amounts and locations.

Faiyaaz Kalimullah, MD, FAAD · Answer

Thank you for your question and for submitting your photos.  Although Botox injections can reduce wrinkling in the lower eyelids when smiling, this technique require VERY careful patient selection.  If the treatment is performed on improperly selected patients, or if the muscle is relaxed too much due to improper technique/dosing, it can actually worsen the appearance of lower eyelid laxity and create bags under the eyes.  The effects of Botox typically last 3-4 months, and you should start to see gradual improvement over the course of the next several weeks.  Best of luck!

Loose and dropped skin under eyes, worse after botox under lower eyelids? Almost looks like I need a lift? (photo)

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