While traditionally used to address forehead lines and crow’s feet or even lips, Botox’s application under the eyes is a newer trend. The skin around the eyes is particularly delicate and prone to early signs of aging, such as fine lines, wrinkles, and under-eye bags, making it a prime target for rejuvenation efforts.

However, treating the under-eye area with Botox requires a detailed understanding of facial anatomy and the potential risks. This area is sensitive and complex, and an improper approach can lead to complications, such as drooping or an unnatural appearance. So, it’s essential to weigh the benefits against the risks and to be fully informed before undergoing the procedure.

That’s why we’ll explore how the treatment works, who it’s best suited for, potential side effects, and how it compares to other under-eye treatments.

How Does Botox Under the Eyes Work?

Botox under the eyes targets the tiny muscles that cause fine lines and creases. Essentially, it relaxes these muscles by blocking nerve signals. This makes it perfect for softening the creases you get from smiling or squinting.

Since the skin under the eyes is delicate, Botox is injected in very small amounts, so the results look natural and refreshed without the risk of drooping. While Botox doesn’t add volume like fillers, it’s an excellent solution for smoothing out dynamic wrinkles. Just keep in mind that the effects typically last less than half a year.

Benefits of Botox Under the Eyes

Let’s explore each of them in more detail.

Aesthetic Enhancements

The primary aesthetic benefit of Botox is reducing fine lines, marionette lines, and wrinkles, often called “crepey” skin.

These wrinkles are usually the result of aging, sun damage, and repetitive facial expressions, which contribute to the loss of elasticity and smoothness in the under-eye area. Botox smooths these lines by relaxing the underlying muscles, resulting in a more youthful and refreshed appearance.

Non-Surgical Alternatives

We all want to look better, but we are not ready to “go under the knife” forever.

So, if you want to rejuvenate the under-eye area without going to invasive surgery, Botox is a highly compelling alternative. Traditional surgical procedures like blepharoplasty (eyelid surgery) involve incisions, longer recovery times, and a higher risk of complications — something we all want to avoid.

Botox is a minimally invasive procedure that can be completed in a matter of minutes, with only a tiny needle and no need for anesthesia (unless you want it). The lack of incisions makes Botox an attractive option if you want to improve your appearance without the commitment and recovery associated with surgery. This non-surgical approach allows for subtle enhancements, so it’s perfect for natural-looking improvement.

Prevents Future Wrinkles

Since Botox temporarily paralyzes the muscles that cause facial expressions, it can prevent future dynamic wrinkles—those lines that form from repeated facial movements.

Studies have shown that regular Botox treatments can prolong the skin’s youthfulness in treated areas.

Helps with Under-Eye Hollows

The skin loses collagen and elastin as we age, leading to a sunken appearance in the under-eye area. This hollowing effect can create dark circles, often perceived as signs of fatigue or aging.

While Botox primarily relaxes muscles, it can be used to lift the skin around the under-eye area, enhancing volume and improving the overall contour. By relaxing the depressor muscles, Botox can allow for a slight elevation of the surrounding tissue, which can diminish the appearance of hollowness.

Quick and Minimal Downtime

One of the most appealing benefits of Botox under the eyes is the quick and convenient nature of the procedure. The treatment generally takes only 10 to 15 minutes, which is why it is called a “lunchtime procedure.”  Most people say it feels like a small pinch, so any discomfort is usually minimal.

Another significant advantage is that most patients can resume their normal activities immediately after the procedure, with only mild swelling, bruising, or redness that usually resolves within a few days. So, you won’t have to take extended time off work or social engagements.

Temporary and Adjustable Results

A unique advantage of Botox is its temporary nature.

If you don’t like your new look — don’t worry — the effects of Botox last between three to six months. Therefore, you can fine-tune results over time or even wait for them to disappear entirely if that aligns more with your facial anatomy or aesthetic goals.

If you like the results, you don’t have to wait for the effects of Botox to gradually wear off; you can go to subsequent sessions and keep the same look for a prolonged period.

Botox Under Eyes vs. Dermal Fillers: Which Is Better?

When it comes to under-eye treatments, choosing between Botox and dermal fillers depends on what you’re trying to fix because they are not inherently better than the other. Botox is your go-to to reduce fine lines and creases caused by muscle movement, like when you smile. On the other hand, dermal fillers are better if you’re dealing with volume loss or deeper hollows under the eyes. Fillers plump up the area, making them ideal for more pronounced signs of aging that Botox can’t tackle.

If you’re just looking to smooth out fine lines, Botox might be all you need. But if you want to restore volume or address dark circles, fillers might give you the results you’re after. Sometimes, combining both treatments gives the best outcome. It’s always a good idea to consult an expert to determine what will work best for your specific needs.

How Much Does Botox Under the Eyes Cost?

The cost of Botox under the eyes can vary, but generally, you’re looking at a range between $200 to $500 per session. Botox is priced by the unit, with each unit costing between $10 and $20. Most people need around 1 to 3 units per eye, depending on the severity.

Remember, since Botox is considered a cosmetic procedure, insurance won’t cover it. And because the effects only last 3 to 6 months, you’ll need follow-up treatments to maintain the results. Always go to a qualified professional who can give you a proper breakdown of what you’ll need and what it’ll cost.

Risks and Potential Side Effects of Botox Under the Eyes

Since you are here to find out everything about benefits, but also risks, now is the time to address that topic. Before delving into side effects and risks, keep in mind that Botox is generally one of the safest treatments when avoiding high-ris k areas.

Common Side Effects

Like any cosmetic procedure, Botox under the eyes can result in some common side effects:

• Bruising: Bruising occurs when the needle punctures small blood vessels during injection. This is the most common side effect and typically resolves within a few days. The extent of bruising can vary depending on the individual’s skin type and the skill of the practitioner.
• Swelling and Redness: Temporary swelling and redness result from the body’s natural response to the needle.
• Discomfort or Pain: Patients may experience mild discomfort or short-lived pain during or after the injection.

These side effects are harmless and temporary, but being aware of them can help manage expectations and reduce anxiety.

Specific Risks of Under-Eye Botox

The under-eye area is particularly sensitive, and improper technique or dosage can lead to several issues:

• Unnatural Results: Over-injection of Botox in the under-eye area can result in an unnatural, “frozen” look. This happens when too much of the toxin paralyzes the muscles, inhibiting natural expressions like smiling or squinting. Since the muscles around the eyes play a vital role in facial expressions, even small changes can alter the overall appearance, making the face look expressionless or stiff.
• Drooping (Eyelid Ptosis): One of the more concerning side effects of Botox is eyelid ptosis, or drooping of the upper eyelid. This occurs when Botox migrates or is injected incorrectly into muscles that control the eyelid, leading to impaired muscle function. In severe cases, ptosis can partially cover the pupil, obstructing vision. Although this condition is temporary and typically disappears, it can last several weeks and significantly affect daily life.
• Asymmetry: Botox must be injected with precision to ensure both sides of the face maintain symmetry. If Botox is unevenly distributed between the two sides, the result can be asymmetry, where one eye or side of the face appears different from the other. Asymmetry might manifest as one eye looking more open or one side of the face appearing less expressive. While minor asymmetry may be corrected with additional injections, more apparent differences can be very difficult to address.

Complications and Unintended Outcomes

Beyond the typical side effects, there are more severe complications that are very rare but still can happen:

• Ectropion: Ectropion is a condition where the lower eyelid turns outward, away from the eye. Ectropion may require surgical correction if it does not resolve on its own.
• Diplopia (Double Vision): Botox can migrate to muscles that control eye movement, leading to diplopia or double vision. This occurs when the toxin weakens these muscles.
• Allergic Reactions: A small number of patients experience an allergic reaction to Botox. Symptoms can range from mild (itching or rash) to severe (difficulty breathing or anaphylaxis).

Who Should Consider Under-Eye Botox?

Under-eye Botox is most suitable for individuals with early signs of aging:

• Younger adults: In their late 20s to 40s, looking to prevent or treat early wrinkles. This does not mean older individuals cannot benefit from the treatment.
• Those with realistic expectations: Those who understand the limitations of Botox and are seeking subtle improvements.
• Healthy individuals: People without significant medical conditions that could complicate the procedure.

Non-Candidates

Botox under the eyes is not suitable for everyone:

• Severe under-eye bags or hollows: These may require surgical intervention for optimal results.
• Pregnancy or breastfeeding: Botox is not recommended during pregnancy or breastfeeding.

What Are the Alternatives to Botox for Under-Eye Rejuvenation?

If Botox doesn’t feel like the right choice for you, there are plenty of other options for rejuvenating the under-eye area. As we already mentioned, dermal fillers are a popular alternative.

Laser treatments, like fractional CO2 lasers, can also help by tightening the skin and boosting collagen production. For less invasive options, you can try chemical peels to improve skin texture or even topical treatments with ingredients like retinol or peptides.

Microneedling is another alternative that can stimulate collagen production in the area, helping to improve the skin’s appearance over time. It’s all about finding the right fit for your particular concern.

Wrapping Up

This treatment can help you rejuvenate your appearance without surgery, making it an attractive option for most people.

The benefits of Botox are notable, no doubt, but it’s essential to approach this treatment with a complete understanding of the potential risks involved. The under-eye area is particularly sensitive, and choosing an experienced, qualified practitioner is crucial to minimizing complications.

A successful Botox treatment under the eyes begins with a thorough consultation, where you will be fully informed about the procedure, then continues during the procedure itself, and ends with careful post-treatment.

Ultimately, the key to a positive Botox experience lies in understanding the procedure, weighing the benefits and risks, and selecting a skilled provider.

Frequently Asked Questions (FAQ)

Can Botox under the eyes help with dark circles or puffiness?

Botox is not typically effective for dark circles or puffiness. These issues are usually caused by pigmentation or fluid retention, which require different treatments like fillers or topical creams.

How many units of Botox are usually required for under-eye treatment?

The number of Botox units needed for under-eye treatment varies but typically ranges between 1 to 3 units per side. A skilled practitioner will assess the specific needs of each patient to determine the appropriate dosage.

Can Botox under the eyes be combined with other cosmetic procedures?

Yes, Botox under the eyes can be safely combined with other cosmetic procedures like dermal fillers or chemical peels. Combining treatments can enhance overall facial rejuvenation, but talking with a qualified practitioner is a must.

What age is appropriate to start getting Botox under the eyes?

There’s no specific age to start Botox under the eyes, but it’s often considered by individuals in their late 20s to 40s when fine lines first appear. Early intervention can help prevent deeper wrinkles from forming.

Can Botox be used to treat under-eye veins or discoloration?

Botox is not effective for treating under-eye veins or discoloration. These issues are best addressed with treatments like laser therapy or specialized creams.

Can Botox under the eyes cause vision changes?

Botox under the eyes rarely affects vision when administered correctly. However, improper injection technique can potentially cause temporary issues like blurred vision or eyelid drooping.

References

Flynn TC, Carruthers JA, Carruthers JA, Clark RE 2nd. Botulinum A toxin (BOTOX) in the lower eyelid: dose-finding study. Dermatol Surg. 2003 Sep;29(9):943-50; discussion 950-1. doi: 10.1046/j.1524-4725.2003.29257.x. PMID: 12930337.

Flynn TC, Carruthers JA, Carruthers JA. Botulinum-A toxin treatment of the lower eyelid improves infraorbital rhytides and widens the eye. Dermatol Surg. 2001 Aug;27(8):703-8. doi: 10.1046/j.1524-4725.2001.01038.x. PMID: 11493292.