Eye-area wrinkles overlap lines that crease when you smile and lines that remain without expression. Botulinum toxin (Botox) briefly reduces that muscle, and a skin booster addresses skin texture.
The two injections are placed side by side because their targets differ. Consultation does not start from a ranking of popular procedures, but from what kind of line is visible now.
3-line summary
1. Lines that deepen when you smile are addressed with Botox; texture that remains even at rest is addressed with a skin booster.
2. The upper eyelid is thinner than other parts of the face, and ultraviolet light and repeated expression leave lines earlier.
3. After Botox, expression returns in a few months; a skin booster is scheduled across several sessions.
Start by separating the lines that crease when you smile
If they fan out only when you smile broadly, they are lines made by the muscles around the eye repeatedly folding the skin. If an indented crease is still visible after the expression is released, it is closer to skin texture and elasticity. Both types often sit together in one area.
| Category | Lines that deepen when smiling | Lines that remain without expression |
|---|---|---|
| When they are seen | When smiling or squeezing the eyes shut | With expression released |
| Main cause | Repeated contraction of the muscles around the eye | Changes in texture and elasticity, accumulated sun |
| Injection looked at first | Botox | Skin booster |
Why the eye area creases first
In measurements taken directly at several sites on the face, the upper eyelid was a thinner site than other parts of the face. Even with the same folding and sunlight, lines show earlier.
When Korean women's upper eyelids were measured by age group, thickness values were similar. The increase in lines is closer to repeated expression and ultraviolet light than to reduced thickness. Sunlight is a major environmental factor in skin aging.
The U.S. authorization label states that outer eye-area wrinkles arise from contraction of the muscles around the eye. Blinking and smiling repeatedly fold the same muscle. Sunscreen and sunglasses are a baseline for reducing future accumulation, rather than reversing lines already creased.
Wrinkles that Botox reduces
Botox briefly reduces the outer eye-area muscle so that lines that crease when you smile stand out less. The scope of the U.S. authorization label is temporary improvement of eye-area wrinkles. The clinical studies that supported authorization were conducted with manufacturer funding, and the reaction the label lists for the eye-area item is eyelid swelling.
Expression begins to weaken within a few days after treatment. It is not a procedure that fills a hollow under-eye, so shadow and hollowing are referred to filler consultation. The mechanism and how it differs from other injections can be followed in the Botox treatment guide and the Botox vs filler comparison.
The texture a skin booster addresses
A PN (polynucleotide) skin booster is an injection that places nucleic-acid chains purified from salmon germ cells into the skin. It does not reduce expression muscles. In a small comparison that placed Rejuran on one side and hyaluronic acid on the other, three times at two-week intervals, satisfaction scores were similar, and texture and elasticity measures rose more on the PN side. This comparison was conducted with manufacturer funding.
It is not a one-session schedule that ends immediately after injection; texture is reviewed across several sessions. Product lines can be checked in the Rejuran treatment guide and the Rejuran Healer guide, and a type comparison in the skin booster types guide.
| Item | Botox | Skin booster |
|---|---|---|
| Lines addressed | Lines that crease when smiling | Texture that remains without expression |
| What it does | Briefly reduces the eye-area muscle | Injected into the skin to address texture |
| Schedule | After one session, again when expression returns | Split across several sessions |
| Same-day reaction | Eyelid swelling, bruising | Redness, swelling, bruising |
※ Botox eyelid swelling is from the authorization label; the skin booster schedule is based on a small manufacturer-funded comparison. Session count and product differ, so cost is given as a consultation estimate.
Five questions to ask before consultation
Asking the items below as written separates which injection is discussed today.
- □ Whether the line now visible deepens only when smiling, or remains without expression as well
- □ Whether today's injection reduces muscle, or addresses skin texture
- □ If Botox is used, how eyelid swelling and drooping are viewed
- □ If a skin booster, the session count and interval
- □ Pregnancy or breastfeeding, neuromuscular disease, inflammation at the injection site, anticoagulants
Temporary redness, swelling, and bruising at the injection site are shared. Shared precautions are in the treatment safety guide.
Frequently asked questions
Q1. Does an eye-area injection hurt?
It stings when the needle goes in. The eye area is thin, so bruising is common, and numbing cream is often applied before treatment. Avoid rubbing the site hard or using a sauna on the same day.
Q2. How many skin booster sessions are needed?
Rather than a one-session schedule, it is split across several sessions. Session count and interval are set to the product and the skin.
Q3. How long does Botox last?
After a few months, expression returns. In a manufacturer-funded eye-area clinical study, duration among people who had a response was around four months. The next appointment is set when expression returns.
Q4. Can Botox and a skin booster be done together?
A muscle injection and a texture injection have different targets, so they are sometimes placed in one plan. Whether they are done on the same day is decided after looking at where swelling and bruising would overlap.
Q5. Who postpones the appointment?
The appointment is postponed if there is inflammation at the injection site. Allergy to a Botox formulation, pregnancy or breastfeeding, neuromuscular disease, and anticoagulants are disclosed before booking.
Results, duration, and suitability vary with individual skin condition, age, and lifestyle, and the same outcome cannot be guaranteed.
Procedures may cause temporary redness or swelling, and contraindications may apply, so please confirm these during your consultation.
This article is general information and does not replace individual medical care. Please confirm diagnosis and treatment suited to your condition during a consultation.
Sources
- U.S. FDA, BOTOX Cosmetic authorization label (2013) — PDF body. Temporary improvement of moderate or greater lateral canthal lines associated with the orbicularis oculi; contraindications (hypersensitivity to the formulation, infection at the injection site); eyelid swelling as an adverse reaction in the eye-area item; retreatment shorter than 3 months was not evaluated. This is the 2013 label and later revisions may exist.
- PMID 25347451 Carruthers et al., eye-area wrinkle phase 3 (abstract). Moderate or greater eye-area wrinkles when smiling. Manufacturer-employee authors and funding. Response was more frequent than placebo, and adverse reactions were mostly mild or moderate. Dose and units are limited to this formulation.
- PMID 27110893 Baumann et al., duration from the two phase 3 studies above (abstract + PMC full text). Manufacturer employees, research funding, and stock. Median duration among day-30 responders around four months. The body states that units cannot be converted between formulations.
- PMID 26508650 Chopra et al., facial skin thickness by site (abstract). 10 cadavers, 39 sites. Sites with thin dermis and total thickness: inner upper eyelid. Not living skin or a Korean sample.
- PMID 16770183 Hwang et al., upper-eyelid thickness and age (abstract). 61 Korean women, skin collected during double-eyelid surgery. Thickness differences between age groups were not marked. Not a study that measured wrinkle depth.
- PMID 12437452 Fisher et al., review of photoaging mechanisms (abstract). Frames sunlight as a major environmental factor in skin aging. Did not measure eye-area procedure effects.
- PMID 32248707 Lee et al., PN vs hyaluronic acid eye-area comparison (abstract + publisher funding statement). 27 people, Rejuran vs non-cross-linked hyaluronic acid, 3 sessions at 2-week intervals. Manufacturer (Pharma Research Products) funding + institutional research funds. Satisfaction scores similar, texture and elasticity measures higher on the PN side. No serious adverse reactions reported (abstract). Topic is similar to the retracted Pak 2014 (PMID 25473210) but it is a separate paper.
Related reading
Sources
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