Real Botox Under Eyes Side Effects and Fixes

Botox under the eyes is safe for most people, but like any treatment, it can have a few side effects. Before you decide to get it done, I’ll tell you here what you should know about the possible effects.

Botox Under Eyes Side Effects​

Here are the effects you can expect:

1. Mild pain, swelling, or bruising at the injection site

After Botox injections under the eyes, mild swelling, tenderness, or bruising may occur as the needle irritates small blood vessels. This is temporary and usually fades within a few days. Applying ice packs and avoiding alcohol or blood thinners before treatment can reduce the risk.

2. Headache, dizziness, or flu-like symptoms

Some individuals may experience mild headaches or dizziness after Botox due to local muscle relaxation or a short-term immune response. These symptoms usually resolve within 24–48 hours and can be managed with hydration, rest, and mild pain relief if necessary.

3. Dry eyes, excessive tearing, or eye irritation

Botox can sometimes affect the nearby muscles that help control tear production. This may lead to dry eyes, excessive tearing, or irritation, especially in people with sensitive eyes. Using artificial tears and avoiding rubbing the area can help relieve discomfort.

4. Hollowness under the eyes

Over-relaxation of muscles or poor injection placement may make the under-eye area appear sunken or hollow. This happens when the skin loses its natural tone and structural support. A skilled injector can prevent this by using precise doses and proper technique.

5. Puffy eyelids or droopy eyelid (ptosis)

If Botox spreads to nearby muscles responsible for lifting the eyelids, temporary drooping (ptosis) can occur. This side effect usually appears within a few days and lasts 2–6 weeks. Applying cold compresses and using prescribed eye drops may speed up recovery.

6. Fat bulges near the injected area

In some cases, muscle relaxation under the eyes may cause small bulges of fat to become more visible. This occurs when Botox reduces tension in the orbicularis oculi muscle, allowing fat pads to protrude slightly. It usually improves as the body adjusts to the treatment.

Here’s: Everything about under eyes Botox!

7. Crooked smile, drooling, or dry mouth

If Botox unintentionally spreads to nearby facial muscles, it can interfere with expressions and saliva control. This may lead to a temporary crooked smile, mild drooling, or dry mouth. These effects fade as muscle activity returns to normal within a few weeks.

8. Allergic reaction — rash, hives, or swelling

Though rare, an allergic reaction can occur when the body reacts to botulinum toxin or its additives. Signs include redness, hives, itching, or swelling around the eyes, lips, or throat. Immediate medical care is required if breathing difficulty or severe swelling develops.

9. Spread of toxin beyond the intended area

Botox can migrate to nearby tissues, causing unintended muscle weakness. This may result in issues like drooping or facial imbalance. To avoid this, injectors must use the correct dosage, technique, and post-treatment care, such as avoiding rubbing or massaging the area.

10. Nausea or diarrhea

Some patients report mild digestive discomfort, such as nausea or diarrhea, after Botox. This is thought to be related to a temporary immune or stress response. Staying hydrated and resting typically resolves these symptoms quickly.

11. Urinary problems or difficulty urinating

In extremely rare cases, Botox can affect the autonomic nervous system, leading to temporary urinary retention. This is more common in patients with pre-existing neurological conditions. Medical attention is needed if urination becomes painful or infrequent.

12. Crusting or drainage from the eyes

If Botox disrupts tear gland balance, mild crusting or watery discharge can develop. This usually clears up within a few days as the eyes regain moisture balance. Gentle cleansing and artificial tears help manage irritation effectively.

13. Eyelid swelling or increased swelling post-injection

Swelling may increase temporarily after injections due to mild inflammation or fluid retention. It’s a normal part of healing and usually subsides in 2–3 days. Keeping the head elevated and applying cold compresses can reduce puffiness.

14. Irregular heartbeats or cardiac symptoms

Though very rare, some individuals may experience palpitations or irregular heartbeat if the toxin affects the body systemically. This reaction requires immediate medical evaluation to rule out allergic or neurological causes.

15. Facial asymmetry

If Botox affects one side more than the other, temporary facial asymmetry may occur. This imbalance happens due to uneven muscle relaxation. It’s correctable either by touch-up injections or naturally resolves as the Botox wears off.

16. Muscle weakness or stiffness

Over-relaxation of nearby muscles may cause temporary weakness or stiffness, especially around the eyes or cheeks. It’s harmless and fades as muscle strength returns. Light facial exercises may help restore balance faster.

17. Blurred or double vision

If Botox spreads into the muscles controlling eye movement, it may cause blurry or double vision. This condition is temporary but requires rest and avoiding tasks that strain the eyes. Proper injection placement prevents this issue.

18. Breathing problems or shortness of breath

In rare systemic reactions, Botox can interfere with muscles used for breathing. This is a medical emergency requiring immediate attention. Always ensure treatment is done by a licensed, experienced injector to minimize this risk.

19. Incontinence (loss of bladder control)

Although uncommon, systemic spread of Botox may affect bladder muscles, leading to temporary leakage or difficulty controlling urination. This typically resolves as the toxin’s effect fades. Seek medical advice if symptoms persist.

20. Trouble speaking or swallowing

When Botox migrates near muscles responsible for swallowing or speech, mild slurring or throat tightness may occur. This is temporary, but can be uncomfortable. Avoiding lying down immediately after injections helps reduce this risk.

Also see: Botox under eyes before & after results!

21. Eye pain or light sensitivity

Botox can cause eye pain or photophobia (light sensitivity) if the eye muscles or nerves are irritated. These effects are usually short-lived and respond well to rest, cool compresses, and lubricating eye drops.

22. Inflammation of the cornea (keratitis)

Botox can cause incomplete eyelid closure, leading to corneal dryness or inflammation known as keratitis. It requires prompt treatment with moisturizing drops or ointments to prevent eye damage.

23. Hoarseness or change in voice

If Botox affects the nearby muscles in the throat, voice changes or hoarseness can occur. This occurs due to the temporary weakening of vocal cord muscles and usually resolves within a few weeks without intervention.

How To Minimize The Risk Of These Side Effects?

After knowing about the side effects, don’t worry. And don’t overthink what I’ll do if my Botox under the eyes goes wrong. Just follow the right step, and you’ll be safe and smooth. The most important thing is choosing someone who truly knows what they’re doing. Always go to a board-certified injector who understands the face and the delicate under-eye muscles. This one choice alone prevents most problems.

Before your appointment, tell your doctor everything about your health. Mention any medicines, allergies, or past cosmetic treatments. This helps them adjust the dose and avoid reactions like swelling or uneven results. Never hide any detail — honesty keeps your skin safe.

Once you get Botox, take care of the treated area gently. Don’t rub or press your eyes, and avoid lying down or bending forward for a few hours. This keeps the Botox in the right place and lowers the risk of drooping or puffiness.

Lastly, give your body time to heal. Drink water, rest, and use soft, soothing skincare products. Avoid hot showers, gym workouts, or saunas for at least a day. These steps are helpful for you to recover quickly and make your results look natural and fresh.

A Note from Dr. Mahnoor

Under-eye Botox can make a beautiful difference when it’s done safely and thoughtfully. If you’re thinking about it, take your time to learn, ask questions, and find someone who truly understands your skin and goals.

Every face is different — and that’s what makes it special. My advice is simple: don’t rush, choose wisely, and always put safety first. If you’re unsure or want to talk about whether Botox is right for you, I’d be happy to guide you through it. Your confidence should come with care — not risk. 💖