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Botox
Under eye wrinkles while smiling after Botox. How do I deal with these lines?
Sometimes patients may notice worsening undereye wrinkles after Botox treatment of the crow's feet. When treating the crow's feet, you are selectively paralyzing the lateral portion of the orbicularis oculi muscle, which is a circular muscle that goes around the entire eye. Subsequently, when you smile and contract this muscle, you may notice more muscle activity at the lower part of the muscle since the outer portion is paralyzed from the Botox. You can try 1-2 units at the under eye to help soften these wrinkles but it is considered an off-label treatment. Make sure to see an experienced injector.
Clinical Context
The skin and muscle under the eye are thinner than at the crow's feet, so even small amounts of Botox can have a noticeable effect there. Using too much, or placing it in the wrong spot, can cause puffiness, asymmetry, or a heavy look when smiling — especially if you already have under-eye fat pads or looser skin. Because there's little room for error in this area, it's usually treated with very small doses and checked before adding more.
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