LAM FACIAL PLASTICS

Dr. Lam,

How do you feel about using BOTOX for crows feet and lines under the eyes?

I've read online reviews of patients in other states who had great results with BOTOX in these areas, and also some where, weeks after the procedure, patients developed droopy, chipmunk-like cheeks and increased puffiness under the eye (something they descrbed as weaking of the lower eyelid muscle causing the fat pockets to herniate). How does one avoid these bad side effects? Have you ever seen such side effects from patients who had BOTOX around their eyes?

Thanks for your assistance!

in 95% of patients botox helps around the eyes. the person you are talking about that can have risks are as follows:
1. much older with bad lid tone. you pull the lower lid down and instead of snapping back, it just slowly retracts. that is a bad situation.
2. someone following bad lower eyelid skin flap surgery where the muscle is compromised. that is why i do not cut on the skin.
3. someone with a "malar bag", abnormal cheek tissue that may cyclically swell.
i can generally spot about 80 to 85% of these outliers but not always. if botox worsens the condition, just stop doing it. if you don't do botox, the wrinkles will definitely get worse. so in short, it is worth trying it in experienced hands.
best,
sml