The under-eye area is often the first place to show signs of aging and fatigue. Those fine lines, subtle hollows, and persistent dark circles can make you look tired even when you're well-rested.
As an aesthetic practitioner at Hertford Cosmetics, I've seen firsthand how concerns about the under-eye area can significantly impact confidence and self-image.
Many clients are surprised to learn that Botox can be used in this delicate area, alongside other treatments, to create a refreshed, rejuvenated appearance. But treating the under-eye region requires exceptional skill, anatomical knowledge, and a refined approach.
Let's explore how Botox can be used around the eyes, what it can (and can't) address, and how it compares to other treatment options.
Understanding Under-Eye Concerns: Beyond Just Wrinkles
Before discussing treatment options, it's important to understand the different issues that can affect the under-eye area:
Crow's Feet (Lateral Canthal Lines)
These dynamic wrinkles extending from the outer eye corners are caused by repeated muscle movements when smiling or squinting. They're one of the most common concerns around the eyes and respond extremely well to Botox treatment.
Under-Eye Wrinkles (Infraorbital Lines)
Fine lines directly under the eyes can develop from muscle movement, skin thinning, and loss of elasticity. These can include both dynamic wrinkles (appearing with facial expressions) and static wrinkles (visible even at rest).
Tear Trough Hollows
The subtle depression that can form between the lower eyelid and cheek creates a shadow that contributes to a tired appearance. This is primarily caused by volume loss and structural changes rather than muscle activity.
Dark Circles
Often genetic or related to vascular issues, dark circles can be exacerbated by thin skin in the under-eye area. They may appear more pronounced with age as skin thins further.
Eye Bags and Puffiness
Caused by fat pad protrusion, fluid retention, or skin laxity, this concern creates a puffy, aged appearance beneath the eyes.
Knowing exactly which concern you're dealing with is essential for selecting the right treatment approach.
At Hertford Cosmetics, we conduct detailed facial analysis to identify the specific issues affecting your under-eye area before recommending any intervention.
Botox for Under-Eye Concerns: What It Can and Cannot Do
Botulinum toxin (Botox, Dysport, or similar neuromodulators) works by temporarily relaxing targeted muscles. This mechanism makes it suitable for some—but not all—under-eye concerns.
What Botox Can Effectively Treat:
Crow's Feet (Lateral Canthal Lines)
This is the classic and approved use of Botox around the eyes. By relaxing the orbicularis oculi muscle (the circular muscle surrounding the eye), Botox can dramatically reduce these expression lines. Treatment creates a smoother appearance while still allowing for natural expression.
A UK clinical evaluation showed that appropriate Botox treatment for crow's feet resulted in 85% of patients experiencing significant improvement lasting 3-4 months [1].
"Bunny Lines" (Upper Nose Wrinkles)
These lines that appear on the upper nose when you scrunch your nose often accompany eye expressions and can be treated alongside crow's feet for more comprehensive rejuvenation.
Lower Eyelid Lines (Very Carefully)
Some practitioners use micro-doses of Botox to treat fine lines under the eyes. This advanced technique, sometimes called "micro-Botox" or "baby Botox," uses minimal amounts placed very precisely to soften fine lines without affecting eye function.
A Subtle Brow Lift Effect
Strategic Botox placement around the eyes can create a slight lifting effect that opens up the eye area, making you look more refreshed and alert.
What Botox Cannot Effectively Address:
Tear Trough Hollows
Because these are caused by volume loss and structural changes rather than muscle activity, fillers are typically more appropriate than Botox for addressing hollows.
Dark Circles (Primary Treatment)
If dark circles are your main concern, Botox alone won't provide significant improvement. Other approaches like fillers, chemical peels, or laser treatments may be more effective.
Under-Eye Bags
Fat protrusion and skin laxity causing bags require either fillers to blend the transition, energy-based skin tightening, or in some cases, surgical intervention.
Deep, Static Wrinkles
Once wrinkles are deeply etched into the skin and visible at rest, Botox may soften but not eliminate them. Combination approaches are typically needed.
Michael, a 42-year-old client, said to me recently that: "I was skeptical about using Botox around my eyes, worried it would look frozen or unnatural. The precise technique at Hertford Cosmetics gave me a refreshed look without anyone knowing I'd had treatment. My crow's feet are significantly reduced but I can still smile naturally."
The Under-Eye Botox Procedure: Precision and Safety
Treating the under-eye area with Botox requires exceptional precision due to the delicate nature of the tissues and the close proximity to important muscles involved in eye function.
The Hertford Cosmetics Approach:
Comprehensive Consultation
Before any treatment, we conduct:
Detailed facial analysis in various expressions
Discussion of your specific concerns and goals
Review of alternative or complementary treatment options
Realistic explanation of expected results
Thorough health history review
Treatment Protocol
Our under-eye Botox treatments follow a meticulous process:
Cleansing of the treatment area
Precise marking of injection points while you're sitting upright
Application of ice or topical numbing if desired
Ultra-fine needle injection using appropriate doses
Gentle pressure to prevent bruising
Immediate post-treatment instruction
Safety First
Safety measures include:
Careful placement to avoid the mid-pupillary line (reducing risk of ptosis)
Conservative dosing, particularly for first-time treatments
Micro-droplet technique for more natural results
Prevention of diffusion to unintended muscles
The entire treatment process takes only about 15-20 minutes, with most clients describing the sensation as a brief pinch that subsides immediately.
Results and Recovery: What to Expect
When performed correctly, under-eye Botox treatment should provide subtle yet noticeable improvement without obvious signs of having had "work done."
Typical Results Timeline:
24-48 hours: Initial effect begins
7-14 days: Full results develop
3-4 months: Results typically last this long, sometimes longer with repeated treatments
Recovery Expectations:
There's virtually no downtime with under-eye Botox. You may experience:
Tiny injection marks that resolve within 30-60 minutes
Possible minor bruising in some cases (easily concealed with makeup)
No interference with normal activities
Emma, 38, shares her experience: "I had Botox for my crow's feet during my lunch break and returned to work afterward. No one noticed I'd had anything done, but over the next week, colleagues kept commenting that I looked well-rested and refreshed."
Potential Side Effects and How We Minimise Them
When performed by experienced practitioners, under-eye Botox has a very low complication rate. However, it's important to understand potential side effects:
Possible Side Effects:
Bruising: Small bruises at injection sites (occurring in approximately 10% of treatments)
Asymmetry: Slightly different results on each side (typically minor and adjustable)
Eyelid ptosis: Drooping of the upper eyelid (very rare with correct technique)
Dry eyes: Temporary change in tear production (uncommon)
Our Risk Minimisation Approach:
At Hertford Cosmetics, we employ several strategies to minimise these risks:
Expert practitioners with specific training in periocular anatomy
Conservative dosing strategy
Precise injection techniques
Proper post-treatment instructions
Follow-up assessment to ensure satisfaction
A review of over 5,000 under-eye area Botox treatments found that when performed by experienced practitioners, significant complications occurred in less than 0.5% of cases [2].
Complementary Treatments: Creating Comprehensive Results
For many clients, the most satisfying results come from combining Botox with other treatments that address different aspects of under-eye aging.
Effective Combinations Include:
This powerful combination addresses both dynamic wrinkles and volume loss:
Botox reduces crow's feet and expression lines
Hyaluronic acid fillers restore volume in tear troughs
Together, they create comprehensive rejuvenation of the entire periocular area
Botox + Skin Quality Treatments
Improving skin quality enhances Botox results:
Chemical peels address surface texture and pigmentation
Microneedling stimulates collagen for improved skin thickness
Laser treatments target vascular causes of dark circles
Botox + At-Home Care
Supporting professional treatments with appropriate home care extends and enhances results:
Retinol products for collagen stimulation
Peptide-rich eye creams for skin structure
Antioxidant serums for environmental protection
Consistent sun protection to prevent photoaging
Who Is an Ideal Candidate for Under-Eye Botox?
Under-eye Botox can benefit many people, but it's not the right solution for everyone.
Ideal candidates typically:
Have dynamic wrinkles that appear with facial expressions
Are in good general health without neuromuscular disorders
Have realistic expectations about potential results
Are not pregnant or breastfeeding
Have no history of adverse reactions to botulinum toxin
Are willing to follow pre and post-treatment instructions
Less suitable candidates include those with:
Primarily volume-related concerns (hollows, bags)
Extremely thin lower eyelid skin
Unrealistic expectations
Certain medical conditions affecting neuromuscular function
Alternative Treatments for Under-Eye Concerns
If Botox isn't the right fit for your specific concerns, several effective alternatives exist:
For Tear Trough Hollows:
Use of hyaluronic acid fillers specifically designed for this delicate area
Creates immediate improvement in hollowing
Results last 9-18 months depending on product and metabolism
Requires exceptional skill and anatomical knowledge for safe application
PRP (Platelet-Rich Plasma)
Uses your body's own growth factors to stimulate regeneration
Gradual improvement in skin quality and minor volume enhancement
Very low risk of adverse reactions
May require multiple sessions for optimal results
For Skin Quality and Texture:
Improve skin texture and minor pigmentation issues
Stimulate collagen production over time
Available in various strengths for customized treatment
Typically require series of treatments for optimal results
Read our recent post on What is a Chemical Skin Peel?
Microneedling
Creates controlled micro-injuries that stimulate collagen production
Improves skin thickness and quality
Can be enhanced with radiofrequency for deeper effect
Requires multiple sessions for significant improvement
Read our recent post on What is Microneedling?
Cost Considerations for Under-Eye Botox
The investment in under-eye Botox treatments varies based on several factors:
Typical UK Price Range:
At Hertford Cosmetics, under-eye area Botox treatments typically range from:
£160 for crow's feet only
£180-£200 for comprehensive eye area treatment (including crow's feet, bunny lines, and under-eye)
Value Considerations:
When assessing value, consider:
Quality of products used
Comprehensive consultation process
Follow-up care and adjustments if needed
Expected duration of results
Investing in quality treatment from experienced practitioners typically provides better value than seeking the lowest price, particularly for this delicate area.
Preparing for Your Under-Eye Botox Treatment
To ensure optimal results and minimise potential side effects, preparation matters:
Pre-Treatment Guidelines:
One week before: Avoid blood-thinning medications and supplements (with doctor's approval)
48 hours before: Avoid alcohol consumption
24 hours before: Stay well-hydrated
Day of treatment: Arrive without eye makeup
Post-Treatment Care for Optimal Results
Proper aftercare helps maximise results and minimise complications:
After Your Treatment:
First 4 hours: Avoid touching or rubbing the treated area
First 24 hours: Skip intense exercise, saunas, hot tubs
First 48 hours: Avoid alcohol consumption
First week: Minimise prolonged sun exposure
For maximum benefit: Make facial expressions periodically during the first few hours to help the product distribute optimally
The Hertford Cosmetics Difference: Our Approach to Under-Eye Treatments
At Hertford Cosmetics, our approach to under-eye treatments emphasises:
Medical Expertise
All practitioners have specific training in periocular anatomy
Advanced injection techniques for natural-looking results
Comprehensive understanding of potential complications and management
Personalised Treatment Plans
Recognition that no two faces age identically
Customised approach based on your unique anatomy
Combination recommendations when appropriate for optimal outcomes
Natural-Looking Results
"Less is more" philosophy for under-eye treatments
Focus on refreshment rather than obvious change
Preservation of natural expressions and animation
Getting Started: Your Under-Eye Rejuvenation Journey
If you're considering under-eye Botox or related treatments, the first step is a comprehensive consultation at Hertford Cosmetics.
During this appointment, we will:
Analyse your specific concerns
Discuss appropriate treatment options
Create a customised plan
Address questions and concerns
Provide clear information about expected results
Under-eye concerns often represent one of the most emotionally significant aspects of facial aging. With appropriate treatment selection and expert application, significant improvement is possible with minimal risk and downtime.
Ready to explore your options for under-eye rejuvenation?
Contact Hertford Cosmetics today to schedule your personalised consultation.
References
[1] British Journal of Dermatology. (2023). "Efficacy and Safety Analysis of Periocular Botulinum Toxin Applications: A Five-Year Review."
[2] UK College of Aesthetic Medicine. (2022). "Complication Rates in Periorbital Neuromodulator Treatments: Analysis of 5,214 Procedures."
_edited_edited.png)
Comments