Want Under Eye Botox? Here’s What You Should Know Before Booking an Appointment

In cosmetic dermatology, the muscular bulges that emerge beneath your eyes when you smile are known as jelly rolls. Some people love them, and others hate them. If you’re in the latter category, under-eye Botox—or jelly roll Botox—may be an option to consider. 

The skin around our eyes is substantially thinner and more delicate than other areas of our bodies, often making it the first to show signs of aging. People typically get Botox injected in the muscles near their temples to reduce the appearance of crow’s feet, but you can also get Botox under your eyes to address those jelly rolls. 

Ahead, board-certified dermatologists Reshmi Kapoor, MD, and Hee Jin Koh, MD, share how exactly under-eye Botox works to smooth out jelly rolls, how it’s different from under-eye fillers, and what side effects may come along with getting Botox under your eyes.

How does Botox work?

Botox, like its alternatives Dysport, Xeomin, and Jeuveau, is a neuromodulator—namely botulinum toxin type A—that blocks the signals that nerves release to cause muscles to contract. When injected into the face, Botox smoothes skin by “temporarily relaxing facial muscles that contribute to deep lines and wrinkles,” Dr. Kapoor explains. Again, Botox is temporary, so its results will only last up to three months, Dr. Koh adds.

Can Botox be used under the eyes?

Technically, yes, Botox can be used under the eyes. However, Dr. Koh points out that it is considered an off-label usage. Botox is not approved for injections under the eyes by the Federal Drug Administration (FDA) like it is for the forehead, frown lines, and crow’s feet. With this in mind, under-eye Botox should only be performed by an experienced physician, Dr. Kapoor says. You can find one near you by searching for board-certified dermatologists on the American Academy of Dermatology’s website, she adds. 

Benefits of under-eye Botox

Jelly rolls are formed by the muscles of your lower eyelids (scientifically known as the orbicularis oculi). When Botox is injected under your eyes into these muscles, it reduces the appearance of jelly rolls and smooths out the skin under your eyes, Dr. Koh says. Plus, Dr. Kapoor says that relaxing the muscles that cause jelly rolls with under-eye Botox can make eyes appear wider and help them stay open when you smile.

Under-eye Botox vs. under-eye filler

Under-eye Botox and under-eye filler have two different mechanisms and sets of benefits. To put it simply, one smoothes; the other plumps. Under-eye Botox targets and relaxes muscles, so it’s best for reducing the appearance of “under-eye wrinkles that form when smiling or squinting,” Dr. Koh says. However, Dr. Kapoor adds that this procedure cannot help with under-eye bags, puffiness, dark circles, and hollowness under the eyes. 

Under-eye fillers, on the other hand, address those concerns by plumping up the under-eye area. Dr. Kapoor says that hyaluronic acid fillers, like Juvéderm and Restylane, are typically the best options for this. They are known to restore volume loss, help with hollowing, and improve dark circles.

No matter which injectable is best suited for your under-eye concerns, Dr. Koh highly recommends consulting with your cosmetic provider for a personalized evaluation and recommendations best suited for your needs.

How to prepare for under-eye Botox

The preparation for under-eye Botox is no different than the preparation needed for any other injectable treatment, Dr. Koh says. As usual, cosmetic consultation with an experienced physician is an essential first step. 

If you are deemed a suitable candidate for under-eye Botox, Drs. Koh and Kapoor advise again drinking alcohol and taking any blood-thinning medications and supplements that aren’t medically necessary for seven to 10 days before your procedure to reduce the risk of bruising. This includes aspirin, ibuprofen, vitamin E, fish oil, gingko, and even garlic.

How much does under-eye Botox cost?

According to the American Society of Plastic Surgeons, the average cost of botulinum toxin injections is $528. The price of under-eye Botox, though, varies depending on the provider. “Some offices will charge a per-unit price, and some will charge a per-area price,” Dr. Kapoor says. 

Side effects

Botox is generally a safe cosmetic procedure. The most common side effects are swelling, bruising, or pain around the injection site. “With under-eye Botox, there is a risk that if an individual is not an appropriate candidate, relaxing the jelly roll muscle can lead to a lag of the lower eyelid margin and, potentially, dry eye,” Dr. Kapoor says. 

Final Takeaway 

Under-eye Botox can be an incredible option for those hoping to smooth the skin under their eyes, especially those who want a wide-eyed look when they smile. Just be sure to find a board-certified dermatologist who is well-versed in this off-label usage of Botox.