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Eyelid Surgery
Can botox get rid of puffiness under eyes? Mine are quite bad and permanent and I'm Only 35
Unfortunately, Botox can not correct lower eyelid puffiness. Botox works by relaxing muscle movement, so it helps with wrinkles caused by repeated expressions. The puffiness you're describing is usually caused by fat pads that bulge forward with age or genetics, and that stays the same whether your face is at rest or moving, so relaxing muscle won't change its shape.
The use of fillers in the tear troughs might help with camouflaging, or you could be a good candidate for a lower blepharoplasty, which removes or repositions the fat directly. Filler results are temporary and need touch ups, while surgery addresses it more permanently but involves recovery time. I recommend making an appointment for thorough evaluation and consultation with an experienced plastic surgeon, who can look at your skin, fat, and lower lid position to tell you which option fits you best.
Clinical Context
Under-eye puffiness at this age is usually caused by fat pads that have shifted forward with age or genetics, not by muscle activity. That's different from the dynamic wrinkles Botox treats, which come from repeated muscle movement. Because this puffiness stays the same at rest or with expression, relaxing muscles won't change its shape. Treating it usually means addressing the fat and skin directly, through fillers to soften the transition or a lower eyelid procedure to remove or reposition the fat.
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