Can You Get Btx Under Eyes? Complete Guide & Safety

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Mechanics Of Under Eye Btx Injections

Yes, you can receive Btx injections under the eyes, though this remains an off-label application. The treatment targets the orbicularis oculi muscle, which encircles the eye and contributes to expression lines. During your botox treatment, the practitioner administers precise micro-doses beneath the lower eyelid to relax specific muscle fibres without compromising natural facial movement.

Under-eye botox injections address dynamic wrinkles – those appearing during facial expressions – rather than static creases visible at rest. After receiving botox in this delicate zone, patients should wait at least 24 hours before taking a hot shower or engaging in strenuous exercise that increases blood flow to the treatment area.

Addressing Dynamic Lines & Jelly Rolls

“Jelly rolls” refer to the muscle bulge that appears when you squint or smile intensely. This bunching of the orbicularis oculi creates a ridge beneath the lower lash line. The injection technique involves strategically placed micro-units of neurotoxin that soften muscle contraction without creating a frozen appearance.

Clinical observations suggest that 1-3 units per injection site typically achieves optimal smoothing whilst preserving natural expressiveness. Patients receiving botox for jelly rolls should avoid rubbing the area and refrain from a hot shower for several hours post-treatment to prevent unintended toxin migration.

Safety & FDA Off-Label Status

Whilst FDA-approved for crow’s feet treatment, under-eye botox injections remain off-label for the infraorbital region. This distinction matters because the injection requires advanced anatomical knowledge compared to standard forehead applications. The proximity to the eye itself, combined with thinner skin and complex vascular networks, demands heightened precision.

After your injection, you’ll receive specific aftercare instructions, including guidance on when you can safely shower after botox and which activities to avoid during the initial settling period.

Botox vs. Dysport For Delicate Areas

Both Botox and Dysport function as botulinum toxin type A, yet their formulation differences create distinct diffusion patterns:

Dysport: Spreads more readily through tissue, creating smoother transitions
Botox: Offers more localised effect for precise muscle targeting
Selection factors: Muscle strength, skin thickness, treatment goals

Regardless of which product you receive, wait at least four hours before lying flat and avoid hot shower exposure that could promote unwanted toxin diffusion.

Common Cosmetic Issues Treated

Under-eye btx injections specifically address muscular concerns rather than volumetric or pigmentation issues. The procedure excels at smoothing movement-related lines but cannot resolve structural problems like herniated fat pads or melanin deposits.

Reducing Crinkling & Fine Lines

The crepey texture appearing beneath your eyes during smiling results from repeated orbicularis oculi contractions. When you receive btx injections targeting these dynamic movements, the neurotoxin reduces muscle activity creating these fine etchings.

Key benefits for fine lines:

Softens expression-related wrinkles around lower lash line
Reduces skin bunching during smiling
Creates smoother under-eye texture
Prevents deepening of existing creases

Following your injection, practitioners typically advise patients to shower after btx using lukewarm rather than hot water for at least 24-48 hours, as excessive heat may increase inflammation and bruising.

Limitations On Eye Bags & Dark Circles

This represents a crucial distinction: btx treatment cannot eliminate true under-eye bags caused by prolapsing orbital fat or reduce hyperpigmentation creating dark circles. In some cases, relaxing the orbicularis oculi muscle may actually worsen bag appearance by removing the muscular “girdle” containing protruding fat.

Patients should wait at least 48 hours after receiving btx before making judgements about puffiness, as initial swelling typically subsides within this timeframe. Avoiding hot shower exposure during the first day helps minimise inflammatory responses.

Softening Crow’s Feet Extension

Crow’s feet originating at the outer eye corner frequently extend beneath the eye along the orbital rim. Strategic btx injections can address both areas simultaneously. After your btx treatment, avoid rubbing the area and shower after btx using moderate water temperature rather than hot shower settings that could increase bruising risk.

Ideal Candidates For Under Eye Injections

Not everyone qualifies as a suitable candidate for under-eye btx injections. A thorough assessment determines whether you’ll achieve satisfactory results or require alternative interventions.

Assessing Skin Elasticity & Snap Test

Practitioners often perform a “snap test” – gently pinching the under-eye skin and observing how quickly it recoils. Healthy, elastic skin springs back immediately, indicating good candidate status for btx treatment.

Elasticity indicators:

Excellent: Skin rebounds instantly (ideal candidate)
Moderate: Slight delay in recoil (proceed with caution)
Poor: Significant lag or no rebound (consider alternatives)

Patients with reduced skin tone face higher risks of complications, including ectropion (lower lid malposition). Post-injection, all patients should wait at least 24 hours before applying heat, including during a hot shower.

Impact Of Existing Eye Bags

If you already present with prominent eye bags caused by herniated orbital fat, under-eye btx injections may prove counterproductive. When you receive btx that relaxes this muscular barrier, the fat may appear more prominent. Following any btx treatment, avoid hot shower exposure and wait at least four hours before lying down.

Realistic Expectations For Mature Skin

Patients over 50 or those with significant photoageing often require combination therapies rather than btx injections alone. Mature skin presents both dynamic wrinkles (addressable with neurotoxins) and static creases plus volume loss (requiring fillers or resurfacing). After receiving btx, mature skin may show bruising more readily. Practitioners advise these patients to shower after btx using gentle techniques and avoid hot shower temperatures.

Btx vs. Dermal Fillers vs. Blepharoplasty

Understanding these three modalities helps you select the most appropriate intervention for your specific under-eye concerns.

Volumizing With Tear Trough Fillers

Tear trough fillers utilise hyaluronic acid to physically fill the hollow groove between lower eyelid and cheek. This addresses volume loss rather than muscle movement. Think of fillers as “filling a valley” whilst btx injections “relax a hill” – they solve opposite problems.

When you receive both injection types, aftercare becomes particularly important: avoid hot shower exposure, don’t massage the area, and wait at least 24 hours before applying makeup.

Surgical Lower Blepharoplasty Solutions

When excess skin hangs in pronounced folds or orbital fat herniation creates persistent bulging, btx treatment offers insufficient correction. Lower blepharoplasty surgically removes or repositions these structures, providing permanent results. Your surgeon will provide comprehensive post-operative instructions far more extensive than the simple guidance to shower after botox using lukewarm water.

Laser Therapy & Microneedling Options

Surface texture concerns respond better to resurfacing technologies than btx injections. Many patients undergo laser treatment following their under-eye btx injections once the neurotoxin has fully settled. After receiving btx, wait at least 14 days before scheduling aggressive resurfacing.

Procedure Details, Pain & Side Effects

Under-eye btx treatment follows a specific protocol designed to maximise safety whilst minimising discomfort in this sensitive area.

Injection Process & Sensation

The procedure typically takes 10-15 minutes. Your practitioner may apply topical anaesthetic cream 20 minutes beforehand, though many patients find under-eye btx injections more comfortable than lip treatments.

What to expect during the procedure:

Skin cleansing and marking injection points
Optional topical anaesthetic (15-20 minutes)
Series of 2-4 micro-injections per eye
Brief pressure applied to minimise bruising
Ice pack application if needed

After receiving btx, you’ll receive instructions about when you can shower after btx – usually after 4-6 hours, avoiding hot shower temperatures for the first 24 hours.

Potential Bruising & Swelling Risks

The under-eye area contains extensive vascular networks, making bruising more likely than with forehead or crow’s feet btx treatment. Approximately 30-40% of patients experience some discolouration lasting 7-10 days.

After the procedure, avoiding hot shower exposure, alcohol consumption, and strenuous exercise for 24 hours helps reduce bruising severity. Wait at least six hours before applying concealer.

Rare Risks: Ectropion & Asymmetry

Ectropion – where the lower eyelid pulls away from the eyeball – represents the most concerning potential complication. This occurs when excessive toxin weakens the structural support of the lower lid. Whilst temporary (resolving as the neurotoxin wears off over 2-3 months), it proves uncomfortable.

After receiving btx, follow all aftercare instructions carefully, including guidance to shower after btx using gentle techniques and avoid rubbing the treated area.

Timeline For Results & Longevity

Under-eye btx injections follow a predictable timeline, though individual variation occurs based on metabolism, muscle strength, and dosing.

Initial Onset vs. Peak Results

Don’t expect immediate transformation after your btx treatment. The neurotoxin requires time to bind to nerve endings.

Results timeline:

Days 1-2: No visible changes; maintain aftercare protocols
Days 3-5: Initial softening becomes noticeable
Days 7-10: Continued improvement
Days 10-14: Peak results achieved

During this settling period, avoid hot shower temperatures, don’t massage the area, and wait at least 24 hours before applying eye makeup.

Duration Of Effects In Lower Eyelid

Under-eye btx injections typically employ lower doses (2-4 total units per eye) compared to forehead treatment. This conservative approach means effects may diminish slightly faster – approximately 2-3 months versus 3-4 months for higher-dose areas. You can safely shower after botox using your regular routine once the initial 24-hour precaution period passes.

Maintenance Frequency Recommendations

Most practitioners recommend repeat under-eye btx treatment every 3-4 months to maintain optimal smoothing. Each subsequent btx treatment follows the same aftercare protocol: wait at least 4 hours before lying down, avoid hot shower exposure for 24 hours, and refrain from vigorous exercise.

Preparation & Aftercare Guidelines

Following evidence-based protocols before and after your under-eye btx injections significantly influences outcome quality and complication risk.

Supplements & Medications To Avoid

Discontinue blood-thinning substances at least one week before receiving btx to reduce bruising likelihood.

Items to discontinue 7-10 days before treatment:

Fish oil and omega-3 supplements
Vitamin E exceeding 400 IU daily
Ibuprofen, aspirin, and NSAIDs (unless medically necessary)
Ginkgo biloba and garlic supplements
Excessive alcohol consumption (48 hours prior to injection)

After your btx treatment, you can resume these supplements once any bruising has resolved, typically within 5-7 days.

Immediate Post-Treatment Restrictions

The first 4-6 hours following your injection prove most critical for proper toxin settling.

First 4-6 hours:

Remain upright – avoid lying down or bending forward
Don’t exercise vigorously
Avoid touching, rubbing, or massaging the treated area
Wait at least 4-6 hours before you shower after btx
Use lukewarm rather than hot shower temperatures

First 24-48 hours:

Skip alcohol consumption
Avoid saunas, steam rooms, and hot yoga
Sleep with head slightly elevated
Continue avoiding hot shower exposure

These precautions prevent unintended toxin migration. Most restrictions relax after the initial day, though avoiding hot shower exposure for 48 hours provides extra assurance.

Makeup Application Rules

Most practitioners recommend waiting at least 24 hours after your btx treatment before applying makeup to the under-eye area. This prevents introducing bacteria through micro-puncture sites whilst they seal. Continue avoiding hot shower steam during makeup removal for the first 48 hours.

FAQ: Under Eye Btx Injections

How Many Units Are Typically Needed?

Under-eye btx injections require remarkably few units compared to other facial areas. Most practitioners administer 1-2 units per eye for mild concerns, whilst stronger muscles may require 3-4 units per side. After receiving btx, follow standard aftercare – wait at least 4 hours before lying down and avoid hot shower exposure for 24 hours.

Can Treatment Worsen Under Eye Bags?

Yes, under-eye btx treatment may temporarily exacerbate existing bags. When the muscle relaxes after receiving btx injections, it no longer provides structural support containing orbital fat. These effects typically resolve within 2-3 weeks. After your injection, proper aftercare – including avoiding hot shower temperatures and sleeping slightly elevated – helps minimise temporary puffiness.

Is It Safer Than Tear Trough Filler?

From a risk perspective, under-eye btx injections carry different but generally less severe potential complications compared to tear trough filler. Filler carries rare but serious risks including vascular occlusion. Btx treatment risks – primarily temporary muscle weakness, bruising, or asymmetry – resolve completely as the neurotoxin metabolises. Regardless of which treatment you receive, wait at least 24 hours before taking a hot shower and follow all aftercare instructions provided by your practitioner.