- Botox is sometimes used to treat wrinkles that appear under the eyes.
- There are some significant risks associated with this treatment.
- Botox cannot treat dark circles or puffy eyes.
As you get older, your skin and facial muscles undergo a number of changes that can affect the appearance of your eyes. Lines and wrinkles start to appear, and you may develop bags or dark circles underneath them.
Botox may seem like a good way to remedy these signs of aging, but there are some risks involved with getting Botox injections under your eyes.
Why is Botox used under the eyes?
Botox is a neurotoxin that is usually used cosmetically to treat wrinkles and fine lines. The active ingredient in Botox is botulinum toxin type A, which works by temporarily paralyzing the facial muscles that cause wrinkles.
Botox is occasionally used off-label to reduce the appearance of under-eye wrinkles, but very rarely injected under the eyes as a standalone treatment.
Instead, some providers will include the under-eye area as an injection site when treating crow’s feet.
What Botox cannot treat
Many people develop dark circles under their eyes as they get older. This is a natural part of aging. Your skin starts to get thinner as you age, which makes the blood vessels underneath more visible and darkens the skin below your eyes. Some people are genetically disposed to developing dark circles under their eyes.
Botox alternatives for dark circles
Given Botox cannot treat dark circles under your eyes, your provider may instead recommend using dermal fillers such as Juvederm or Restylane to fill in the shadows and reduce the appearance of dark circles. Laser treatment, which works by removing pigment from the target area, is another option.
>> Learn more about using Botox and Juvederm together for natural looking results.
It is also common to develop mild swelling under the eyes in one’s later years. As you age, the muscles that support your eyelids gradually weaken, causing some of the surrounding fat to move into your eyelids. This can create puffiness or the appearance of having bags under your eyes.
Botox alternatives for puffiness
While under-eye puffiness can’t be resolved with Botox, there are still a number of treatment options available. Dermal fillers can be used to blend the swelling with the upper cheek and disguise it, while fat transfers can remove excess fat from under the eye. Laser treatments can also be used to tighten up the skin under the lower eyelid and reduce puffiness.
Are you a good candidate for Botox under the eyes?
If your goal is to reduce the appearance of dynamic wrinkles that occur when you use your facial muscles to form an expression, you may be a good candidate for this procedure. Static wrinkles that are visible when your face is at rest cannot be treated with Botox.
Additionally, to qualify as a good candidate, you should ideally:
- Be over the age of 18.
- Already be getting Botox for crow’s feet.
- Have healthy facial muscles, as Botox under the eyes is best suited to younger individuals with good eyelid support and certain older patients who have healthy orbital anatomy.
- Be generally healthy, with no chronic neuromuscular condition or other serious health conditions.
The procedure is not suitable for older individuals with severe facial aging or people with weak or impaired eyelid muscles.
You should also avoid Botox if you are pregnant or breastfeeding as the effect of Botox on unborn and nursing babies is still not fully understood.
What to expect during the procedure
Botox under the eyes is a non-surgical procedure that usually takes less than 30 minutes to complete.
The injections are typically given in your provider’s office using small needles that are injected into the lower part of the orbicularis oculi, a facial muscle that closes the eyelids.
Most providers will only use one or two units of Botox per side. This is a very low dose in comparison to some other treatments, because higher doses tend to increase the risk of complications.
As noted above, Botox is usually injected in the under-eye area as part of a crow’s feet treatment. One study has shown that patients who get Botox in their lower eyelids and crow’s feet area were more likely to report positive results than those who only received injections in their lower eyelids.
Does it actually work?
In some cases Botox will soften the appearance of wrinkles under the eyes.
However, some providers caution that Botox may not be able to resolve under-eye wrinkles due to the fact that many wrinkles that appear in this area are caused by skin laxity and thinning—two issues Botox cannot fix.
In these scenarios, other treatments such as fillers, fat transfer or laser resurfacing are often better options.
Before and afters
How long does it last?
You may not be able to see a dramatic difference immediately after your treatment. Botox generally has an onset time of approximately three to seven days, though in some cases it may take up to a month to see the full effects.
The effects of Botox are temporary. Most patients find that Botox under the eyes typically lasts for roughly three to four months. It’s possible to repeat your treatment after this time if you wish to maintain results.
Side effects of Botox under eye injections
While Botox may be able to help reduce the appearance of wrinkles under the eyes, many cosmetic professionals advise against this treatment due to the relatively high risk of weakening the lower eyelid.
This can result in a variety of cosmetic and medical issues. For example, a weakened eyelid can lead to the lower lid pulling away slightly from the eyeball, which may look unattractive and cause dry eyes, blurry vision, difficulty blinking and other eye problems.
Other common side effects of Botox include:
- Bruising and swelling at the injection site
- Neck pain
- Muscle weakness
- Flu-like symptoms
Seek medical help if your symptoms worsen or persist.
Botox typically costs approximately $12 per unit. Given that you need 16-24 units to treat crow’s feet, it should cost roughly $200-$300 per treatment session, with a small top-up for under eyelid injections.
It’s important to remember that the price can vary depending on your location and the number of units required.
Men tend to require more units than women, due to having stronger facial muscles. As such, the cost of treatment for men may be slightly higher.
Botox is occasionally used under the eyes as part of crow’s feet treatment. However, many providers will recommend against using Botox for this purpose as the potential benefits are modest and the risks relatively high.
Other options like laser treatment and dermal fillers may be better for reducing wrinkles, bags and dark circles under the eyes.
Find a Botox provider
To get the best results and reduce the risk of complications, it is important to always use an experienced Botox provider – especially when you’re dealing with off-label uses, such as under-eye Botox injections.
Use our doctor search tool to find qualified cosmetic professionals in your area.