Is botox better than fillers for under-eye bags?

By Dr. Aaron Stanes

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    If you’re searching for the best treatment for under eye bags, you’ll no doubt come across cosmetic injectables. Renowned for the convenience and effectiveness, two types most commonly used to rejuvenate the eyes are botox and dermal fillers. These treatments are not the same; working in different ways, and targeting different concerns. It’s important that you understand how each treatment works so that you can choose the right option.

    What is botox?

    Botox is a cosmetic injectable treatment that uses a purified protein to relax muscles. When used around the eyes botox prevents skin bunching to soften crow’s feet wrinkles. It can also help with lower eyelid bulging caused by a hyperactive obicularis oculi muscle (known as a jelly roll). Botox is a quick treatment, and needs to be repeated every 3-4 months to maintain the effect.

    What are dermal fillers?

    Dermal fillers are an injectable gel used to add volume and structure to the skin and soft tissues of the face. The give an immediate, fully reversible result lasting 12-24 months on average (although new evidence shows they can last longer especially around the eyes). When injected around the eyes, dermal fillers can reduce hollows, soften dark circles, and camouflage eye bags.

    Is botox or fillers better for under-eye bags?

    While both botox and fillers can be used to rejuvenate the eyes, fillers are a better option for under eye bags. Under eye bags result from age-related changes in the skin and soft tissues around the lower eyelids. The bags are the result of the facial and under eye fat protruding beyond its normal location. Dermal fillers are used to disguise the hollow areas around the eye bags. By smoothing the bags they become immediately less pronounced. One exception is for under eye bulging caused by hyperactive lower eyelid muscles. Known as a jelly roll, this is the bulge of skin seen directly on your lower eyelid. This can be treated with botox.

    Will fillers work for severe eye bags?

    Surgery is the preferred option to treat severe under eye bags. Using fillers in these cases often results in chronic swelling that may persist for years unless the filler is removed. If you have severe festoons or malar bags with dermatochalasis (excess skin), you should avoid cosmetic injectables around the under eye area.

    What kind of results can I expect?

    Treating under eye bags with cosmetic injectables must be done conservatively, often over 2-3 sessions. The under eye area is extremely delicate, and being overly aggressive with fillers can cause long term swelling, skin discolouration and lumps. Don’t expect a perfect result when treating under eye bags with fillers. The goal is to soften the area as much as possible while avoiding any side effects. If you want a more pronounced result than you’ve achieved with fillers, then you’ll need to consider surgery.

    Eye rejuvenation

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