Botox is a treatment commonly done to keep forehead wrinkles and nasolabial folds from forming or deepening. Aside from these areas, Botox is also incredibly popular as an FDA-approved procedure for smoothing out the crows feet and glabellar lines around and between the eyes. In recent years, plastic surgeons have begun to promote Botox as a way to get rid of the dark circles and wrinkles below the eyes as well -- even though it’s not supported by the FDA yet.
So should you have Botox injected under your eyes? Although it’s an off-label use, many patients do benefit from using Botox under the eyes when injected in conjunction to the lower eyelids and crow’s feet. Bags and wrinkles in the areas surrounding the eyes could be reduced in as little as 8 units for each eye, but not without side effects.
Botox is one of the most in-demand cosmetic surgery procedures worldwide, well-known for its ability to paralyze specific facial muscles from tightening and contracting. It's sought after by patients who want to minimize the wrinkles on their faces. But before we discuss the nitty-gritty of how Botox can reduce dark circles and delicate wrinkles under the eyes, it’s important to first understand how the Botox cosmetic itself works.
The ingredients that make up Botox are botulinum toxin type A, human albumin, and sodium chloride. Botulinum toxin is derived from the C. botulinum bacteria, which is commonly found in natural settings like lakes, forests, and soil. Although this bacteria is generally harmless, it can become incredibly dangerous when its spores transform and its cell population increases.
When the C. botulinum bacteria evolves, it will begin producing the deadly neurotoxin responsible for botulism. Scientists have managed to dilute the neurotoxin from its natural form to manufacture medical products like Botox, which is perfectly safe to use with few side effects.
Botox works by blocking the release of acetylcholine, the chemical messenger which signals the muscle cells to contract. When injected, Botox can temporarily relax the muscles and help them become less stiff. After around 3 - 6 months, the effects of Botox wear off and the muscles will begin to contract again.
For patients who have muscle or nerve disorders and similar medical conditions, Botox is often prescribed as a treatment to provide temporary relief. And of course, Botox is most famous as a medication that weakens dynamic muscles and reduces the appearance of wrinkles. It’s frequently used to correct horizontal lines on the forehead, ‘cobblestone’ skin on the chin, lines at the corners of the mouth, and wrinkles between the eyebrows or the corners of the eyes.
Since the late 1980s, Botox has been the go-to treatment for a number of wrinkle types. In the US, Botox was approved to reduce the appearance of glabella lines between the eyes in 2002, and crow’s feet at the corners of the eyes in 2013. However, the US FDA has yet to approve the use of Botox under the eyes for cosmetic purposes. Currently, there is not enough research that shows the effectiveness and potential side effects of Botox for wrinkles and bags directly under the eyes.
In one study with nineteen female participants, some researchers tried to see where Botox could most effectively target wrinkles around the eyes. Some participants received injections in the lower eyelid skin and in the corners of their eyes, while others were injected under the eyes only. The participants who were injected in combined areas found positive results, as the creases around their eyes were minimized.
Their lower eyelids also appeared fuller and plumper, reducing wrinkles and bagginess, compared to those who were injected solely in the muscles below the eyes. Researchers also tried to measure the effects of varying the amounts of Botox injected into the lower eyelids. Patients who received 8 units of Botox observed the strongest results, but experienced the most intense side effects as well.
As this study is the only one available that tackles the question directly, injecting Botox to treat bags and dark circles under the eyes is still an off-label use. Although many providers are unsure about the efficacy of this treatment, some cosmetic surgeons still try to soften the appearance of under-eye wrinkles with Botox -- and find success in it.
It usually depends on whether the wrinkles under the eyes are deep, dynamic wrinkles rather than delicate, fine lines. Botox won’t be able to resolve creases completely; most providers would recommend dermal facial fillers, fat transfer, or laser resurfacing as a better treatment option instead. For the patients who do receive Botox below their eyes, they observe that there isn’t a dramatic difference immediately. It may take approximately 3 - 7 days or even a month to see results. And the effects eventually wear off after 3 - 6 months, much like in other treatment areas.
As you get older, your skin begins to reflect your age. You’ll notice many changes, especially around your eyes, as creases and sagging bags of skin develop underneath. For these problems, Botox is occasionally recommended as an off-label procedure to reduce the appearance of under-eye wrinkles.
However, Botox is very rarely injected under the eyes as a standalone treatment; more often, Botox is injected in the lower eyelids as part of the treatment for crow’s feet. Here are some things you can expect if you’re planning to undergo this type of cosmetic procedure:
Every Botox injection should be performed in a doctor’s office and administered by a board-certified dermatologist, plastic surgeon, or physician who was specially trained in Botox injections. It’s important to find a skilled provider because they are the ones who are most familiar with facial anatomy, so they can deliver safe and effective results.
Once you’ve consulted with an experienced Botox injector to see if you’re a suitable candidate, you will need to return to their office for the procedure.
The overall cost of Botox varies depending on your region and the specialist. Aside from the medication, you’re also paying for the office space, the time and expertise of your provider, and other materials.
In urban areas where there is a lot of competition, you’re more likely to find more affordable Botox rates, especially when compared to rural areas where no other injector is providing the service. Before requesting for Botox injections under your eyes, it’s a good practice to ask for a reasonable price estimate.
Botox is currently priced at around $12 per unit. With the 16 - 24 Botox units for crow’s feet, you may need to spend around $300 - $400 for an initial treatment session, plus more for maintenance top-ups. Men would also need more Botox units than women because they have stronger muscles, so the cost of the procedure may be more expensive for them.
When people think about Botox, they mostly think of it in a purely cosmetic sense. They may be surprised to learn that Botox is actually an effective treatment for a number of medical conditions, including hyperhidrosis (excessive sweating), neck spasms, and chronic migraines. Ophthalmologists also utilize Botox around or under the eyes to treat eye issues that impact vision. From frown lines and crow’s feet to lazy eye, eye twitching, and more, Botox is an incredibly versatile product:
On the other hand, adults who suffer from lazy eye have an underlying condition that causes it; Botox is only recommended as one of the last approaches to managing the problem.
As with every plastic surgery procedure, it’s crucial to consider how the treatment will achieve your goals. If your goal is to reduce the appearance of dynamic wrinkles, which emerge when you make facial expressions, then Botox can certainly help. Aside from determining your aesthetic goals, it’s also good to see if the procedure is safe for you. You can assess this by doing research on who is an ideal candidate, as well as to check on potential side effects which may occur.
The best possible candidate for getting Botox injections below the eyes is someone who is over the age of 18 and is already planning to get Botox to address their crow’s feet. They should have healthy muscles and have no chronic neuromuscular condition, or any other serious health conditions like myasthenia gravis, Lambert-Eaton syndrome, and Lou Gehrig’s disease.
This particular Botox procedure is not suitable for patients with impaired eyelid muscles and older individuals with severe facial wrinkles. It’s best to avoid getting Botox done as well if you are pregnant or breastfeeding, as the effects of the product on unborn and nursing babies are yet to be studied.
Botox has long been applied to a wide range of treatments in the past several decades. It is largely safe. And although it’s not permanent, Botox can offer relief from discomfort, alleviate medical symptoms, and provide life-changing cosmetic effects. However, Botox for under-eye use is not FDA-approved, so there is no full body of research on its safety yet. Still, you can expect commonly-known Botox side effects to occur, such as:
These side effects should wear off in a few hours or days after the injection. Aside from common side effects, under-eye Botox poses added risks because the treatment area is very delicate. Some doctors advise against this treatment due to the relatively high risk of weakening the bottom eyelid.
Weakened eyelids can lead to the lower lid pulling away slightly from the eyeball, which can be unattractive and cause a number of problems like dry eyes, blurry vision, difficulty breathing, droopy eyelids, eye swelling, eye numbness, and difficulty opening the eyes. Patients should also be aware of the signs of a Botox allergy; if the following symptoms occur, seek out emergency medical attention at once:
If you’re concerned about the safety or efficacy of Botox treatment for under-eye wrinkles, you should consider talking to your cosmetic surgeon about other viable options. There are actually many ways to reduce those unwanted eye bags that develop as your skin thins with age. Some great alternatives are:
For younger patients who haven’t noticed severe wrinkling and loose skin yet, it may be good to practice at-home strategies and daily habits to prevent under-eye deterioration. Some useful tips to follow are:
Ethos Spa is New Jersey’s premier med spa. With our board-certified surgeon and highly-professional medical team, we bring you the best services in cosmetic surgery. We have performed thousands of Botox procedures on countless patients, so we’re well-aware of various patient concerns, goals, and needs. Ethos Spa prioritizes patient safety and satisfaction above all else; you’re sure to be in good hands with us.
Consult with our well-trained and experienced Botox providers at our luxurious clinic. Schedule your first appointment with us today.
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