Botox for under eye wrinkles is not generally used, probably because it needs to act on muscle tissue and there is very little of that under the eye. Botox is great for crows’ feet, forehead lines and frown lines where the face is more fleshy, but under the eyes is thin-skinned and quite difficult to work with.
Alternatives to Botox for Under Eye Wrinkles
We know of two good solutions for under eye wrinkles: 1) dermal filler (see below) and 2) blepharoplasty for a more permanent fix.
Dermal Filler for Under Eye Wrinkles
Dermal filler (like Juvederm or Restylane) can be used to fill some lines under the eyes and in the crow’s feet beside the eyes if they are deep. So far we have not found a practitioner who successfully uses Botox for under eye wrinkles, but there are some who use dermal filler quite well in wrinkles under the eyes.
Your physician may chill the area under your eyes, by asking you to hold ice-block sticks under your eyes for a few minutes. This helps minimise the pain. Some ordinary painkillers 30-60 mins before the appointment can also help, but consult your physician if you are worried.
A very fine needle is used to inject the filler. The needle will go into your skin following the wrinkle or line under your eye. It is painful as this is a very sensitive area.
If your crows’ feet lines are also deep, it’s a good idea to use dermal filler on lines beside the eyes and underneath the eyes at the same time, to minimise your cost and get a better overall result.
In that case you will need to have Botox injections beside the eyes a week before you have filler injections on the crows’ feet. If you only want to target the lines or wrinkles under the eyes, you don’t need to have Botox first.
See “Frown Lines” for a fuller discussion of the Botox/dermal filler combination.
After Dermal Filler for Under Eye Wrinkles
At first the result will look red along the lines and wrinkles, rather like cat scratches on your face. The areas will be tender straight after. Make up can cover the red marks, but plan your appointment for the end of the day if you work, so that the skin can settle over night and you are ready for work the next day.
The result will be obvious the next day and more noticeable when the redness has disappeared.
I have only had this procedure once, two years ago and the result was very good. I have not needed to top up these lines again with filler, just continued with Botox beside the eyes (for crows’ feet lines).
About $200 to $400 depending on how much dermal filler is used. Check with your consultant and be guided on how much they feel will be needed for the severity and deepness of the wrinkles.
Another alternative to Botox for under eye wrinkles is a blepharoplasty or an eye-lift, which can be both upper and lower eye, or just upper eye. A blepharoplasty is minor surgery, usually done under local anaesthetic.
Here's some before and after blepharoplasty pics. You can see that the under eye wrinkles are also much improved.
In the case of baggy or very lined skin under the eyes, a blepharoplasty can work wonders in scooping out all fat deposits and tightening the skin after.
See our section on eye-lift for a more detailed discussion