The first time I tried to treat under-eye lines with botulinum toxin, I learned a blunt lesson from my attending: the muscle that makes those lines is not the same muscle Botox is famous for relaxing. That mismatch is why under-eye results are inconsistent, and why a careful plan beats a cookie-cutter approach. If you are staring at fine creases under your eyes and wondering why Botox works wonders for crow’s feet but seems unpredictable for the lower lid, here is how to think about it like a clinician.
What creates lines under the eyes, exactly?
Under-eye lines look similar at a glance, but they arise from a few distinct processes. Sorting them matters more than any brand choice or trendy technique.
There are dynamic lines, caused by the circular muscle around the eye, the orbicularis oculi. When you smile hard or squint, the pre-tarsal and pre-septal portions of that muscle bunch and imprint the skin. These dynamic folds sit just below the lash line and at the outer corner. Botox for crow’s feet works by relaxing the lateral portion of this muscle. Under the eye, the same logic applies, but the space is tighter, the skin is thinner, and the margin for error is smaller.
There are static lines, etched in at rest from years of movement and the skin’s collagen loss. Think of paper that has been folded so many times the crease remains even when you flatten it. These lines persist when you are expressionless. Static lines do not respond dramatically to neuromodulators alone. They need skin quality treatments or a gentle volume strategy.
There is skin laxity and crepe texture, the hallmark of photoaging and intrinsic thinning. You can spot it when the skin looks like tissue paper and folds rather than springs. Laxity responds to collagen-stimulating approaches far better than to muscle relaxation.
There are hollows from orbital fat pad descent, tear trough anatomy, or bone remodeling with age. When light falls into that hollow, it creates a shadow that reads as a line. You can relax the muscle all you want, but a shadow is a contour problem. That is a filler or biostimulator conversation, not primarily Botox.
There are fluid dynamics, puffy mornings, and festoons, which are not the same as filler-related swelling. Hereditary malar edema can exaggerate creases and make any injectable response unpredictable. In these cases, the wrong product in the wrong spot makes things worse.
When a patient says “under-eye lines,” I segment what I see: dynamic fold, static etch, crepe texture, hollow, or fluid issue. Usually there is a mix.
Where Botox helps, and where it does not
Botox for eye wrinkles has earned its reputation on crow’s feet, where muscle movement is dominant and the target is relatively safe. Under the eye, the muscle is thinner and very close to structures that control lower lid position. Relax it too much, and you risk a smile that looks off or a lower lid that sags slightly. That is the crux of why under-eye Botox can be excellent in selected cases and disappointing or risky in others.
It helps when the lines are shallow and clearly movement-driven just under the lashes. When I see fine accordion lines during a big smile that disappear at rest, a micro dose of neuromodulator can soften them nicely. The goal is subtle softening, not freezing. Patients who do best here often already love their Botox for crow’s feet and want a touch more refinement.
It does not help much when the problem is crepe skin or a hollow tear trough. Relaxing the muscle does nothing for tissue thinness or missing volume, and heavy-handed dosing invites lower lid weakness or a smile that feels odd. In severe laxity, Botox can actually expose more crepe by removing the micro-tension that masked loose skin.
Dosing, placement, and why less is more under the eye
Under-eye dosing is small. Typical ranges sit at about 1 to 2 units per injection point, with a total often between 2 and 6 units per side for the inferior orbicularis, sometimes less for first-timers. Compare that with the forehead, where a full treatment can be 10 to 20 units or more. Brands like Botox, Dysport, Xeomin, and Jeuveau each have unit equivalences and diffusion profiles that your injector accounts for. The principle is the same: treat lightly, watch the result, and adjust.
Placement is critical. Safe injections stay superficial, about 2 to 3 millimeters below the lash line, and avoid the medial area near the tear trough. I mark where the dynamic crinkles form during a sincere smile, then I let the smile drop and place small aliquots only where the lines imprint. The aim is to relax the pre-tarsal orbicularis just enough to soften the accordion effect without compromising lid support.
Micro Botox, sometimes called baby Botox, means using even more dilute product and tiny droplets across a broader area. The idea is to reduce fine crinkling by decreasing the firing of superficial muscle fibers and, in some protocols, the activity of the sweat and oil glands in the region. Micro Botox can look very natural for dynamic crepe, but it still does not rebuild collagen or fix hollows.
The risk profile under the eye
Most Botox side effects are transient: pinpoint bruising, minor swelling, and a heavy sensation that fades in days. Under the eye, additional risks include lower lid laxity that reveals more sclera, a smile that looks or feels weaker, and occasional dry eye symptoms if blinking strength changes. These resolve as the product wears off, typically in 8 to 12 weeks for this area because we use small doses.
It is important to stress that “Botox gone wrong” photos online often conflate poor candidate selection with poor technique. If someone has distinct malar bags or festoons, relaxing the orbicularis can unmask puffiness. If the lower lid tone is already lax, even minuscule dosing can create an imbalance. A good injector will test lid snap-back, evaluate your tear trough depth, and look for early signs of festoons before agreeing to treat.
What to expect: before, during, after
A proper Botox consultation includes a few key checks. We review your eyelid history, dry eye symptoms, previous botox injections, prior filler in the tear trough, and any surgeries. I watch you smile big, squint, and speak to see which fibers fire. I often show a mirror and point out whether the lines are movement-driven or present at rest. We talk about what Botox can and cannot achieve for under-eye lines, and whether a combined plan is smarter.
The treatment itself is quick. Numbing cream is optional. The needle is fine, the sting mild, and most patients describe the botox pain level as a 2 or 3 out of 10. Expect a couple of tiny blebs that smooth out in minutes, and occasional botox bruising that fades over a week.
Aftercare is simple: do not rub aggressively, avoid lying face down for a few hours, skip saunas and hot yoga that day, and avoid heavy exercise right after injections. Light activity is fine. If swelling appears, a cool compress helps. Most people see the botox results timeline follow the familiar pattern: gentle onset at day 3 to 5, peak around day 10 to 14, then a gradual fade over 8 to 12 weeks in the lower lid region. Botox longevity in this micro-dosed area is shorter than in the forehead because of dose size and constant muscle use when blinking and smiling.
When Botox is the wrong tool
Static etched lines and crepe skin are where Botox for under eye lines underperforms. If you pinch and release the skin and the wrinkle remains, muscle relaxation will not erase it. Here is where I pivot to skin quality interventions. Resurfacing techniques such as fractional laser, microneedling with radiofrequency, or carefully selected chemical peels can tighten collagen and thicken the dermis. For fine crepe under the lashes, low-energy fractional laser in a series of sessions often yields more reliable smoothing than any neuromodulator.
Volume loss is a different path. If your under-eye “line” is actually the edge of a hollow, neuromodulation will not fill a shadow. Hyaluronic acid fillers can, but the tear trough is unforgiving. Product choice, placement plane, and a conservative approach matter to avoid the Tyndall effect, swelling, or irregularity. In some faces, a better strategy is to support the midface first, lifting the cheek and softening the transition. In others, minute retrograde threads of a thin HA under the orbicularis retaining ligament make sense. For patients with thin skin and frequent puffiness, biostimulators or skin-boosters offer a hydrated, collagen-boosting alternative with less risk of persistent edema.
If festoons or malar edema dominate, injectables rarely solve the issue. Energy devices, surgical approaches, or lifestyle modifications for salt and alcohol may be more relevant. This is also the group where Botox can accentuate the wrong thing by loosening the muscle sling.
Crow’s feet versus under-eye: why outcomes differ
Botox for crow’s feet is a high-satisfaction treatment. The anatomy is generous, the target is lateral, and a standard botox dose softens those fan lines without high risk. Under-eye Botox is a finesse move in a tight zone. The difference in predictability is why your injector may be enthusiastic about treating the outer corners but cautious about the area below the lashes.
That said, combining a small under-eye dose with a standard lateral can create a smooth transition for some faces. Done correctly, the lower-lid smile still moves, just with less crinkling. Natural looking Botox hinges on restraint. I would rather under-treat and invite you back for a touch-up than overshoot and wait weeks for strength to return.
My approach to a first-timer asking about under-eye Botox
A typical scenario: early 30s, well-cared-for skin, fine accordion lines under the lashes when smiling, no lines at rest. I will outline a light plan: 1 unit per point in two to three points under each eye, with standard lateral crow’s feet dosing. I explain the best age to start Botox is less about age and more about the pattern of dynamic movement and how quickly static lines are forming. For someone at the threshold of etched lines, preventative botox makes sense, but I keep the lower lid conservative.
For a patient in their 40s or 50s with both dynamic lines and mild crepe, I will often pair micro Botox under the eye with a collagen-stimulating plan. That might be a series of low-energy fractional treatments spaced 6 to 8 weeks apart, home retinoids, and strict sun behavior. The two together outperform either alone.
For pronounced hollows, we discuss filler. I review botox vs fillers frankly: Botox relaxes muscles. Fillers restore volume and can soften shadows. They are not interchangeable. If the patient has had filler that looks puffy in the morning, I may check for retained product with palpation and consider hyaluronidase before adding anything new. Less product, placed deeper and laterally for support, often gives a cleaner result than chasing the trough itself.
Safety, units, and what influences results
Each brand has its fans, but technique and anatomy trump labels. Whether we use Botox, Dysport, Xeomin, or Jeuveau is less critical than how we dose and where we place. Units are not universal currency across brands, and diffusion characteristics differ slightly. Your injector considers all of that, along with your muscle strength and facial habits.
Two variables outside the syringe matter. First, skin behavior. Smokers, sun lovers, and those with chronic eye rubbing etch lines faster. Second, muscle training and resistance. Rarely, patients report botox not working or wearing off too fast. Most of the time, that is either under-dosing, strong baseline musculature, or long intervals during which the muscle fully retrains. True botox resistance or immunity is uncommon, but it exists. If I suspect it, I may switch to a different formulation or reassess goals.
How to make botox last longer under the eyes is partly about expectations. Because micro doses fade quicker in active muscles, plan for botox maintenance every 8 to 10 weeks if you want constant smoothing. If that cadence feels too frequent, shift focus to collagen-building therapies that create longer-term change in the canvas.
Cost, timelines, and why combined plans are often more economical
Botox cost structures vary by city and clinic, charged per unit or by area. Under-eye micro dosing uses few units, but because the lower lid is an advanced area, some practices price it as an add-on. Filler in the tear trough often costs more upfront than neuromodulators, but if volume loss is the true issue, one well-executed syringe can outperform multiple Botox touch ups. Collagen procedures require patience and a series approach, yet they change the baseline over months. When you add the math, the cheapest path is usually the one that targets the real cause.
Side notes for specific groups
Men often have thicker orbicularis muscles and stronger crow’s feet. Under-eye dosing still stays light. The goal is subtle softening that preserves a masculine smile.
For first timers and anyone planning wedding botox or holiday botox, do not experiment under the eye for the first time right before a major event. Test at least two months prior, watch how you respond, then schedule the final pass 2 to 3 weeks ahead of the date. That timeline respects the botox results timeline and gives room for a tiny touch-up if needed.
If you have chronic dry eye, lower lid laxity, or a history of lower blepharoplasty, under-eye Botox may not be ideal. We can work laterally, improve skin quality, and consider other modalities instead.
Myths, realities, and the middle ground
Several botox myths swirl around the eye area. The idea that Botox always migrates to the eye and causes droop is not accurate. Botox migration problems typically stem from placement and dose, not a mysterious drift across tissue planes. Another myth says more units last longer. In the lower lid, more units can create function problems without meaningfully extending longevity.
On the other side, the botox dangers conversation should be honest. Any injectable has risks, from bruising to rare eyelid malposition. Choose a provider who sees a lot of eyes, not just foreheads. Ask about their plan if you do not like the result. A good clinic has a botox consultation checklist that includes your goals, medical history, eyelid exam, dose discussion, and a follow-up visit to review results. Red flags in botox clinics include one-size-fits-all dosing, pressure to add filler immediately, no explanation of alternatives, and an unwillingness to say no.
How I combine treatments for stubborn under-eye lines
A layered approach wins in most cases. I often start with a light crow’s feet treatment and tiny under-eye droplets. At two weeks, we assess. If dynamic improvement is good but texture remains, we introduce energy-based therapy. For patients nervous about lasers, microneedling with radiofrequency is a workhorse. It tightens the dermis with minimal downtime and plays well with neuromodulators.
For crepe skin with minimal hollow, I like a low-dose, high-frequency retinoid, daytime antioxidant, and genuine SPF habit. Skincare after botox is not complicated, but consistency matters. You can resume actives within 24 hours unless your skin is irritated. Avoid vigorous facial massage or devices over the treated area for a couple of days.
If we need volume, we decide whether to address the midface or the trough. Supporting the cheek often blends the lid-cheek junction better than filling the groove. If a trough needs finesse, we use a soft HA, minimal volume, and meticulous placement. I schedule a review at four weeks, not sooner, because edema can mask the final contour.
When to stop, switch, or skip
Sometimes the answer is not more. If every under-eye Botox session yields transient improvement followed by an odd smile or morning puffiness, I stop. We pivot to skin-led strategies or refer to oculoplastic surgery for a structural solution. If Botox wearing off too fast is your pattern and you need touch ups every six weeks to stay happy, that is another cue to shift tactics.
There is also a cohort who should not get botox under the eyes: those with marked lower lid laxity, festoons, or significant dry eye symptoms. That does not mean no treatment, just different treatment. The satisfaction rate jumps when the tool matches the task.
A simple decision aid you can use at home
- Smile big in bright light. If the lines under your lashes vanish at rest and you like your smile shape, you may benefit from micro Botox under the eyes plus standard crow’s feet. If the lines persist at rest, pinch the skin gently. If it looks thin and pleats easily, prioritize collagen-stimulating treatments and skincare over neuromodulators. If a trough shadow dominates, tilt your head and see if light changes the “line.” If the line is mostly shadow, discuss filler or midface support, not more Botox. If your lids look puffy in the morning or you see bags that worsen with salt and wine, be cautious with any injectable under the eye and seek a targeted plan. If you have had filler there and dislike morning swelling, ask about assessment for residual product and alternatives before adding anything new.
Final thoughts from the chair
Under-eye lines pull you into a crowded landscape of options. The temptation is to try the thing that was magic for your forehead. Botox, when used thoughtfully, can soften dynamic crinkles under the eye, but it is not a universal eraser. The best outcomes come from matching the treatment to the cause: muscle relaxation for movement lines, collagen work for crepe, volume for hollows, and restraint for puffiness-prone lids.
If you want natural looking botox, accept two truths. Less is more under the eye, and combined therapies usually outperform any single trick. Ask your provider specific botox consultation questions: Are my lines dynamic or static? Do I have lower lid laxity? Would I do better with laser or filler first? How many units will you use and where? What is your plan if I look over-relaxed? Those answers, more than a brand name or a trend like baby botox, tell you whether you are on the right path.
Is Botox worth it for under-eye lines? It can be, in the right face and in moderate doses. But the quiet secret behind most enviable before-and-after photos is not a single syringe. It is a sequence: correct diagnosis, conservative neuromodulation, thoughtful collagen building, and, when needed, precise volume. Done this way, Allure Medical Charlotte botox you keep your expression, your smile reads like you, and the camera catches fewer creases. That balance is the point.