by dr. lam » Fri Dec 07, 2007 11:31 pm
Yes, Botox around the eyes is both an art and a science. Also, trying out Botox on you first and making adjustments are important. Let's divide the problem into two ways that Botox may have been injected:
1. BOTOX INJECTED ONLY ON THE OUTER PART OF THE EYELID. If this is the case, then the remaining orbicularis oculi muscle under the eye may be moving against the frozen outer part of the eye to create this shelf or jelly roll under the eye. This would be treated by putting Botox right under the eye to soften the muscle (but would worsen the condition if you have #2 below). Usually problem #1 is only seen during smiling.
2. BOTOX INJECTED BOTH ON THE SIDES OF THE EYES AND A BIT TOWARD THE MIDDLE. Okay, now you may have one of several problems:
a. If Botox was injected immediately under the eye in someone with a mild fat bag and weak muscle tone, the muscle may relax and cause the eyebag to be bigger. There is no treatment for this except time. If this is the problem, you should not have Botox placed too close right under the eye. the other reason to avoid this type of injection is injecting Botox really close to the nose wrinkle can weaken the orbicularis muscle that surrounds the lacrimal sac (tear duct) and cause dry eye temporarily.
b. If Botox were injected into a festoon or malar bag, the area can enlarge either due to a weakeed muscle or aggravation of a malar bag. Some people have an area on the upper outer cheek near the eye that has abnormal looking skin that cyclically gets bigger in the morning or with salt intake. That person should not have a needle injected near the bag. For type 2 problems (both a and b), the abnormality is typically seen whether you smile or you don't.
I have had almost all of these problems with Botox and lecture about Botox all the time as well. However, I would not be scared of Botox but just make sure that your injector knows all of the above stated conditions well enough to help you and to modify the injection for you in the future.
I leave you with this thought that I always say, "If you like my Botox too bad it will go away. If you hate my Botox, don't worry it will go away."
best,
SML