Is Botox under the eyes a smart way to look less tired? Sometimes, but the answer depends on what is actually causing the under-eye issue and whether muscle relaxation will help or hurt. In the right patient, tiny doses can soften crinkling when you smile. In the wrong patient, it can lead to swelling, crepey texture, or even a heavier, more tired look. The under-eye is one of the least forgiving areas on the face, so getting this right demands nuance.
Why the under-eye behaves differently
The skin below the eyes is about 0.5 millimeters thick. It has little support from fat and sits over a ligamentous shelf where light bouncing off the tear trough can deepen shadows. Add a powerful circular muscle, the orbicularis oculi, which squeezes when you smile or squint, and you have a delicate balance of structure and movement. Traditional botulinum toxin use relies on weakening targeted muscles. That principle works beautifully on the forehead, the 11 lines between the eyebrows, or crow’s feet at the lateral corners, where there is more space and stronger skin. Under the eye, that muscle also helps push fluid out of the eyelid. Over-relax it and swelling can pool.
In clinical practice, I often find that patients ask for “under-eye Botox” when they really want brighter, firmer skin, less hollowing, or fewer dark circles. Those goals aren’t always muscle problems, and Botox cosmetic injections are only designed to relax muscle. That mismatch is where disappointment happens.
When under-eye Botox can work
There is a very narrow use case: tiny, superficial doses placed just beneath the lash line to soften fine smile creases that persist only with animation. The ideal candidate has good skin quality, minimal laxity, and no history of morning puffiness. Think of a mid-30s runner with strong lateral crow’s feet, minimal volume loss, and a faint scrunch under the pupil when grinning.
The dose is small, often 1 to 2 units per point, with two or three points per side at most. Some injectors use microbotox or mesobotox techniques here, diluting the toxin to create more of a skin-texture effect without deeply weakening muscle. Even then, you should expect subtle changes, not a dramatic smoothing. Results begin in 3 to 7 days, settle by two weeks, and last around 8 to 10 weeks in this area, sometimes less than traditional crow’s feet dosing.
I frequently pair this approach with lateral crow’s feet treatment, not because under-eye Botox replaces it, but because coordinated dosing can create a harmonious smile. Overdoing the crow’s feet while skipping the medial under-eye can leave a mismatch. Conversely, skipping lateral support and only treating the under-eye can make the central lower lid look heavy.
When it does not help and can even make things worse
The most common mistake is using Botox for problems it cannot fix.
- If your concern is a visible hollow or tear trough, that is a volume and shadow issue, not a muscle problem. Botox will not fill a groove or change how light refracts in a concavity. In some people, relaxing the muscle can actually make a hollow look deeper because the balancing pull is lost. If you struggle with morning puffiness or under-eye bags, weakening the orbicularis can reduce lymphatic pumping and worsen edema. Patients with allergy-related swelling or fluid retention after flights are at higher risk of this side effect. If the skin is lax or crepey at rest, muscle relaxation can unmask creping because the scaffolding effect of muscle tone is reduced. Skin quality problems need skin solutions, not only neuromodulators. If your eyeballs are slightly prominent, an anatomic trait called positive vector, under-eye toxin can expose more of the lower lid and produce a round or startled look. This is one of the quicker ways to regret an overzealous approach.
Anecdotally, I have seen well-meaning overcorrection lead to a dull, tired eye because the gentle squeeze we use when we smile is part of how the lower lid hugs the globe. Remove that completely and expressions look off. I would rather leave a few soft lines than trade them for odd animation.
The difference between treating crow’s feet and the under-eye
Patients often lump crow’s feet and the under-eye together, but the techniques and risk profiles are distinct. Crow’s feet sit at the lateral canthus, where skin is thicker and muscle fibers are broader. A standard botox crows feet treatment uses 6 to 12 units per side in several points, with relatively predictable improvement and a low risk of swelling. Under the eye, doses are lower, diffusion is less forgiving, and the margin for error is smaller. Mixing the two concepts can lead to mismatched expectations.
I frequently treat crow’s feet, glabellar lines between the eyebrows, and forehead wrinkles together as part of a customized Botox cosmetic treatment. That coordinated plan smooths the dominant expression lines, lifts the tail of the brow a few millimeters, and brightens the upper face. The under-eye, when treated, is the finishing touch, not the anchor of the plan.
What the science and experience say about safety
Large trials for Botox cosmetic focused on glabellar, forehead, and lateral canthus lines. The under-eye was never a primary on-label indication, which leaves us with smaller studies and expert guidelines. What we know aligns with practice:
- Low-dose, superficial placement reduces animation lines in select patients. Transient side effects like pinpoint bruising and swelling are common. A small percentage experience prolonged edema, particularly if prone to fluid retention. Rarely, diffusion into the lower lid retractors alters eyelid position or blinking strength, creating dry-eye symptoms. Most cases resolve as the toxin wears off, but they are uncomfortable.
We can minimize risk by careful dose selection, using a tiny needle, avoiding deep passes, and asking about contact lenses, dry-eye history, allergies, and sleep or salt habits. Even with care, the under-eye will never be as predictable as the glabella or forehead.
How an expert evaluates whether you are a candidate
A solid consultation is the difference between a small win and months of frustration. My checklist is simple but strict:
- What exactly bothers you: lines with a smile, hollowness, color, texture, or puffiness? If you cannot name it, we clarify with a mirror and photos at rest and with expression. Do you swell easily in the mornings or after crying, salty meals, or flights? If yes, I lean away from under-eye toxin. Is the skin thin and lax at rest? If crepey without smiling, we shift to skin-directed therapies. Is there a clear groove or shadow that brightens when lifted? Volume or light-scattering solutions make more sense. Any dry-eye, eyelid surgery, thyroid eye disease, or contact lens discomfort? These tilt me away from dosing that could disturb blink mechanics.
When patients fit the narrow profile, I map a very conservative pattern, review the expected subtlety of results, and plan a botox follow up at two weeks to assess symmetry and function. If we need a micro touch-up, we add a unit here or there, not a wholesale rework.
What to expect if you proceed
Under-eye doses are short appointments. Makeup comes off, the area is cleansed, and dots are placed where the muscle bunches with smile. Most people feel a brief pinch. Bruising risk increases with supplements like fish oil, vitamin E, ginkgo, or NSAIDs; pausing those for a week beforehand, if medically safe, helps. Afterward, stay upright for four hours, avoid strenuous exercise the same day, and skip rubbing or facials for 24 hours.
Changes start appearing within a few days. The tell is that your eyes still smile, but the papery creases soften. If anything feels heavy, puffy, or odd, call your injector early. Timing matters for adjustments in adjacent zones, like adding a whisper of product to the lateral canthus to balance the effect.
Alternatives that are often better than under-eye Botox
In many real-world cases, safer and more effective options exist. A layered plan frequently outperforms any single tactic.
Skin quality therapies sit at the top of the list. Non-ablative fractional lasers, gentle resurfacing, and energy-based devices like radiofrequency microneedling can thicken dermis and tighten crepe. I have seen crepey lower lids transform after two to three light passes months apart, with minimal downtime. For surface texture and pigment, medical skincare matters more than people expect. Nightly retinaldehyde or a microencapsulated retinol three nights per week, a morning vitamin C serum, and disciplined sunscreen use can change how light reflects off the lid in 8 to 12 weeks. Some patients do well with polynucleotide or exosome-based treatments around the eye, though data quality varies. When used thoughtfully, they can improve hydration and fine lines without affecting muscle tone.
Volume correction, done conservatively, addresses hollows. Hyaluronic acid fillers, placed deep on bone in the tear trough, can brighten shadows when performed by someone who does a lot of under-eye work. The margin for error here is also slim. Overfilling or superficial placement leads to Tyndall effect, a bluish cast, or puffiness. I often stage this in two sessions, two to four weeks apart, to keep it precise. In patients with long-standing malar bags or festoons, filler is the wrong tool; surgical or lymphatic approaches make more sense.
For true loose skin, lower lid pinch blepharoplasty is still a gold standard. It is brief, local-anesthetic friendly, and removes just enough crepe to restore snap. In the right hands, recovery is a week or two, and outcomes last years, not months.
If you squint, tempering the driver helps too. Thoughtful use of botox crows feet treatment can indirectly reduce under-eye crinkling by dialing down the lateral squeeze. Sometimes, this alone delivers the “less tired” look patients want, without touching the medial lower lid. I often include this as part of a personalized botox plan that may also address forehead lines, the 11s between the eyebrows, and a small brow lift for light and lift through the upper lid.
The role of a microbotox approach
Microbotox, also called mesobotox, uses tiny amounts of diluted toxin placed very superficially to affect sweat and oil glands and fine muscle fibers in the skin rather than the deeper bulk of the orbicularis. On the lower lid, this approach can give a modest tightening and pore-refining effect in thicker-skinned zones like the lateral lower lid and cheek junction. It is not a fix for hollows or substantial wrinkles, but for a subtle camera-ready finish, it can be useful. I view it as a companion to a botox glow treatment across the T-zone, cheeks, and forehead for patients concerned about shine and texture.
A strategic way to sequence treatments
Timelines matter. If your goal is to look fresher for a specific event, work backward. Two to three months out, address skin quality and any volume correction. One month out, refine crow’s feet, glabellar lines, and forehead wrinkles with wrinkle relaxing injections. Two weeks out, if we decide under-eye microdosing is appropriate, we can place a small amount to soften animation only after we see how the upper face settled. This sequence prevents surprises and allows for a botox review session to tune small asymmetries.
Maintenance differs by modality. Botox for facial rejuvenation typically repeats every 3 to 4 months for most people, though some stretch to every 6 months. Fillers often last 9 to 18 months in the tear trough. Laser and energy treatments hold for 6 to 18 months depending on settings and lifestyle. A realistic botox maintenance plan might look like every 4 months in your first year, then extend to every 6 months once baseline lines are softer. Spreading sessions around holidays or seasonal botox specials can help with scheduling and budget, but don’t let a deal choose your dose or areas.
What about dark circles?
Dark circles are a basket diagnosis. They can be pigment, vascular show, thin skin, hollowing, or shadow from a bag. Botox does nothing for pigment or vessels. Topicals like azelaic acid, vitamin C, kojic acid, or cysteamine can help with pigment. Vascular show responds to thicker dermis and sometimes to gentle vascular lasers. Hollows are volume. Bags are surgery or lymphatic work. The first step is parsing which type you have, ideally with bright, neutral lighting and side-by-side photos at rest and with a smile.
How to talk to your injector so you get the right plan
Clarity upfront saves you from chasing fixes later. Bring well-lit photos showing your typical concern, especially in the morning and evening. Describe when the issue is worst and what improves it. If salt, sleep position, or allergies change your look, mention that. Ask your clinician to show you, in a mirror, which lines are muscle-driven versus structural. If they only offer a single tool for every problem, keep asking or seek a second opinion. A customized botox treatment should integrate your expression patterns, eyebrow position, and lower face function, not just attack any line in sight.
In consults, I map a few zones: glabella for the 11s between the eyebrows, forehead for horizontal lines, lateral canthus for crow’s feet, and the lower face if needed for a balanced look. Small touches like a botox brow lift can open the eye, and conservative doses for bunny line treatment at the nose can keep expressions smooth without freezing your smile. If jaw tension or tooth grinding is part of your story, masseter reduction can streamline a square jaw, protect teeth, and lessen headaches, which indirectly softens the overall look of fatigue. Therapeutic botox for migraine relief, shoulder tension, or neck bands can be layered into the same yearly plan if medically appropriate.
Common fears and what’s realistic
The biggest fear is that Botox makes you look fake or expressionless. Under the eyes, the opposite risk is more common: looking puffy or odd if you push the dose. A skillful injector preserves your smile dynamics while quieting excessive crumpling. Expect that you will still crinkle a little when you really laugh. Faces that never crinkle look uncanny because real smiles engage the muscles around our eyes.
Another misconception is that Botox tightens skin or builds collagen. Botulinum toxin is a relaxer. It can create the appearance of smoother skin by quieting movement, but it does not directly thicken dermis. If you want skin tightening, consider radiofrequency microneedling, gentle fractional lasers, or a course of medical skincare. That is where collagen stimulation happens.
Pricing, dosing, and planning for touch-ups
Lower-lid doses are usually small, which might suggest a Check out here lower cost, but the complexity and risk often mean you are paying for expertise rather than volume. Budget for the consult and careful follow-up. I advise booking a botox touch up visit at two weeks anytime we treat around the eyes. If everything looks perfect, great, but it gives you a safety net.
Longevity is shorter under the eye than in larger muscles. Expect 2 to 3 months, sometimes less, for microdoses. If you love the look, consider folding it into a botox yearly plan with every other session including the under-eye, rather than every single visit. That pacing balances benefits and risk of cumulative swelling.
When not to inject under the eyes
I decline under-eye toxin when there is visible fluid pooling at baseline, a history of persistent edema after filler or previous toxin, marked skin laxity, significant eyeball prominence, or active dry-eye disease. I also avoid it soon after a viral illness or during allergy flares when lids are already puffy. In those cases, I redirect to skin work, volume correction if indicated, and gentle lifestyle changes like side-sleeping adjustments or salt moderation. It is better to be a little conservative than to spend months waiting for diffusion effects to fade.
Realistic case patterns
A teacher in her late 30s with faint accordion lines only when she smiles big, normal mornings, and good skin snap is the quintessential under-eye candidate. Two units per point across two small points per side, combined with standard crow’s feet dosing, softened the smile lines without muting expression. She repeated every 10 to 12 weeks for this zone, every 3 to 4 months for the crow’s feet.
A 42-year-old consultant with hollow tear troughs and morning puffiness asked for botox under eyes to look less tired. We skipped toxin there. Instead, we did a staged deep hyaluronic acid filler along the orbital rim, a gentle fractional laser for crepe, and standard glabellar and forehead wrinkle relaxing injections. The net result was brighter, smoother eyes without risking additional swelling.
A 50-year-old runner with great skin but strong lateral pull benefited more from a botox brow lift and a careful lateral canthus plan. We left the medial lower lid alone. She looked more awake thanks to an opened brow and calmer crow’s feet. That approach is often the sweet spot for active patients who dislike any chance of puffiness.
Final judgment calls from the chair
What I have learned, after thousands of neuromodulator sessions, is that restraint around the eye ages well. The eye area announces overcorrection with every blink. If the line only bothers you in cropped, zoomed selfies, think twice. If your goal is a rested, confident face across the whole day, weigh the modest gains of under-eye botox against the higher predictability of lateral crow’s feet treatment, skin quality upgrades, and strategic volume placement.
Under-eye Botox can work, but only under the right conditions, with conservative dosing, and in the hands of someone who treats this zone often. It does not lift skin, fill hollows, or erase dark circles. In many patients, safer alternatives or a combination approach delivers a clearer, longer-lasting improvement.
If you decide to proceed, keep the dose light, plan a follow-up, and be ready to pivot. A customized botox treatment is a tool, not a destination. The best results arrive when your plan respects anatomy, prioritizes function, and stages improvements across skin, muscle, and structure. That is how you look refreshed without looking “done,” and how your eyes stay expressive while the lines stop dominating the conversation.