Facial Injections: Info, Prices, Photos, Reviews, Q&A

Botox can be used to improve wrinkles of the lower eyelid area, but must be done cautiously and by a skilled injector.

This is an advanced technique that has the potential to create problems (such as bruising, worsening of puffiness, and others) if not performed properly.

In the right patient, this can make a very nice improvement. Alternatives might include lower eyelid surgery or laser/chemical peel to the lower eyelid area, depending on the particular patient. (Matthew Richardson, MD, Frisco Facial Plastic Surgeon)

Botox for lower eyelid wrinkles

Although Botox is only approved to improve the appearance of moderate to severe frown lines between the brows and crow’s feet lines, it can be used to smooth lower eyelid wrinkles. I would recommend a low dose (2 units per eyelid).

If the orbicularis oculi muscle is weakened with a large dose, it might cause ectropion or drooping of the lower eyelid. (Karen E. Wells, MD, Tampa Plastic Surgeon)

BOTOX works better for crow’s feet than under-eye wrinkles.

I have not had good success eliminating creases in lower eyelids. In my experience, BOTOX does not work well. These can be softened, but not eliminated, with a careful, delicate, Injectable Filler treatment.(Eric M. Joseph, MD, West Orange Facial Plastic Surgeon)

Undereye wrinkles

Botox in very small amounts may help if the wrinkles under the eye are predominantly present while smiling. You would probably benefit from filler (Restylane) and/or chemical/laser resurfacing of the lower eyelids to tighten/contract the skin in that area. (Bryan K. Chen, MD, San Diego Dermatologist)

Botox for under eye wrinkles

The levator muscle which is involved during smiling, will create a “bunching up” of skin near the eye. This muscle should not be treated as it will provide an unequal smile and can cause drooping of the corner of the mouth on that side looking like you had a stroke or Bell’s palsy.

If your lines underneath the eyelid are present at total rest so that the muscles are not contracted around your mouth and lips, then those lines can be treated by Thermage radiofrequency for tightening, Fraxel or other lasers, and possibly chemical peels.

Botox, used in this off-label indication, may provide a good result, but if there is a tendency for puffiness from fluid retention, then it shouldn’t be done because there may be less pumping action from a sleepy Botox-treated eyelid muscle and thereby less fluid drainage and more fluid accumulation.

Also, your skin elasticity needs to be checked. If there is any deficiency of this skin property, you would be at risk of an ectropion, a condition in which the lower eyelid rolls away from the eye and the tears don’t bathe the eye.

The eye becomes dry and irritated and chronic inflammation and redness ensue. Please see a physician who is very experienced in this field. (Ronald Shelton, MD, Manhattan Dermatologic Surgeon)

How Effective is Botox for Under Eye Wrinkles?

It has to be done by an expert and done very precisely. In fact less is more in the eyelid. If you inject too much Botox the eyelid will become floppy and it will affect the way you look.

Typically a very small dose injected right under the skin and mainly in the outer half of the eyelid. (Naveen Somia, MBBS, PhD, FRACS, Sydney Plastic Surgeon)

Management of fine lines of the lower eyelid

IF the lines get worse with smiling, then yes, Botox may provide you with some benifits. IT also appears that you have slight darkening of the skin, and in these instances, I have occasionally found a mild TCA peel to be of benefit in providing improvment in the skin texture and discoloration. (Otto Joseph Placik, MD, Chicago Plastic Surgeon)

Botox for under the eye wrinkles

I would avoid injecting Botox into this area due to potential ectropion (turning out of the lower eyelid). Botox is much more effective for the crows feet around the eye.

I would recommend consulting with a cosmetic dermatologist about the use of a filler in this area along with a mild chemical peel to soften the wrinkles. (Nissan Pilest, MD, Irvine Dermatologic Surgeon)

A tough area for botox…

a small amount of botox under the eye may be helpful especially in younger individuals with good muscle tone…remember the eyelid muscles are important for closing the eyelids and too much can cause problems…only 1-2 units under the center of the lid with maybe another 1-2 just to the far side may improve your appearance without causing a droop…and if you’re older, stay away from this area… (Ken Landow, MD, Las Vegas Dermatologist)

Botox works well for under the eyes. I use about half of the normal dose for this injection. The concern is, of course, causing the orbicularis oculi muscle to weaken and cause drooping of the eyelid. (Thomas Guillot, MD, Baton Rouge Plastic Surgeon)

Combination treatment is key

The lower eyelid wrinkles are due to a number of reasons and since they are a few of those, Botox alone will not work. Treatments should include:

1. Botox: Crow’s feet and “microdroplet” (0.5-1unit) technique in the wrinkles closer to lower orbital rim.

2. Filler: Restylane or Juvederm Ultra. An HA filler with lower viscosity will provide a fill effect to the area of the tear tough and orbital rim. The filler should be injected deep so that it does not give the skin a bluish a hue to it.

3. Laser: This is what dermatologists just are experts in. A fractionated type of laser, either CO2 or Erbium provides wonders in that area by diminishing lines as well as provide increased elasticity. (Hassan Galadari, MD, Dubai Dermatologist)

Botox for under eye wrinkles? Yes and No.

By now you are probably aware that botox cosmetic is approved for use around the corners of the eyes, an area referred to as smile lines or crow’s feet. The approved areas for injection are lateral or outside the corner of the eye.

Despite that, we most commonly will inject the Botox more toward the area directly under the eye provided the patient meets certain physical examination characteristics to ensure this is a safe option. We should be checking the movement of the lower lid to be sure that its strength can tolerate the relaxation of the muscles.

There are so many tools that can be helpful to influence a very youthful lower eyelid:

1.) Skin tone can be affected by hyperactive muscles and Botox Cosmetic or Dysport can be used in this case.

2.) General loss of volume can cause excess laxity and increasing wrinkling. This can be treated with hyaluronic acid fillers or even a patient’s own fat for transfer.

3.) Aging skin that has lost too much elastic property and collagen content will need to undergo resurfacing to stimulate the body’s healing processes. We commonly will use peels (88% phenol), carbon dioxide fractionated, or erbium lasers to achieve this goal depending on a patients skin type. (Todd Christopher Hobgood, MD, Phoenix Facial Plastic Surgeon)

Botox can be used conservatively by an experienced injector to relax and smooth some of the lower eyelid creases. Too much may cause laxity of the lower eyelid support.

Consult with a board certified experienced injector . (Jeff Angobaldo, MD, Dallas Plastic Surgeon)

Botox and the Lower Eyelid Wrinkle

A small dose of Botox immediately under your lower eye lash line will help smooth some of the hypertrophic (large) muscle that is accentuating your lower lid “lines”. Restylane may be used to add some volume in the lower lid hollow.

Lastly, if all else is not working for you, a conservative skin pinch of excess lower eye lid skin can reduce the skin laxity and “lines”. The area that you are concerned with is a very delicate and unforgiving area so make sure to choose your physician most carefully. (Michael A. Persky, MD, Encino Facial Plastic Surgeon)

Lower lid wrinkles of the eye

The lower eye lid can be treated with botox and also with filler. The filler may help soften the wrinkling. The botox can improve lateral crow’s feet. I would avoid injecting botox in the lower eyelid, because it may lead to ectropion.

If all else fails, a small skin pinch excision can help. (Steven Wallach, MD, New York Plastic Surgeon)

Botox under the lower lid

You can safely use Botox along the lateral orbital rim for crow’s fet. Under the lower lid though you need to be extremely sparing so as not to drop the lid down. You will always have lines there but maybe they can be slightly softened by Botox.

It’s worth a try but make sure the injector has lots of experience and knows to be conservative. (Richard P. Rand, MD, FACS, Seattle Plastic Surgeon)