Featuring Gail Keir, BSN, RN
When it comes to beauty, we all know the eyes have it. That said, even the brightest eyes can use a little boost now and then. Enter: Botox.
Botox for the eyes is seeing a surge in popularity and with good reason. Botox injections for the eye area can be used to address a wide spectrum of common cosmetic concerns - from crow’s feet to under-eye bags.
Cosmetic Nurse Injector Gail Keir, BSN, RN is a skilled practitioner with over 15 years of experience injecting neurotoxins, fillers and administering other aesthetic treatments including lasers, medical-grade chemical peels, microneedling, and more.
She is based in Orange County where her highly-customized treatments and artist’s touch keep clients coming back. We recently chatted with her and she shared a wealth of knowledge about this trending topic in the world of Botox. Read on to learn her top tips and best practices.
Why Botox for the Eye Area?
According to Keir, many men and women begin experiencing signs of aging in their late twenties or early thirties. Over time, repetitive facial expressions can create deeper lines in the skin. Keir notes that there are a variety of factors that play a role in causing the eye area to age prematurely.
“A lot of us don’t get enough sleep, we’re dehydrated and we may have allergies affecting our eyes and the skin around them that can make us look older,” Keir explains. “There are also contributing hereditary factors and aging. These changes under our eyes and the appearance of crow’s feet become more apparent and visible because the skin around our eyes is thinner and more delicate. As we age, we lose fat and collagen, and also have years of squinting in the sun which deepens wrinkles, not to mention UV sun damage.”
Botox for Crow's Feet
Perhaps the most popular application of Botox for the eyes is treating crow’s feet, the wrinkles that form at the outer corners of the eyes from squinting, sun damage, etc. Keir says Botox can have a dramatic effect on correcting this common aging concern. Botox relaxes the muscles around the area and can, with consistent upkeep, retrain targeted muscles over time, revealing softer and smoother skin.
“I just love the bright-eyed, natural look that people get after treating their crow’s feet,” Keir says. “You look really well-rested without taking your own twinkle away from your personality.”
Botox for Under-Eye Bags
Botox injections, when used lightly under the eyes, can help reduce the appearance of under-eye bags. Since Botox softens the muscles, Keir says a combination treatment is the best approach for addressing under eye concerns. Using filler to address volume loss in the under eye and tear trough area is a popular off-label treatment.
“In some instances, Botox can be used and have a positive effect for under eyes and bags,” she explains. “However, a combination effect is usually better and may provide the best results. That’s when you could use a neurotoxin like Botox and a filler as well.”
Though Botox on its own will soften the muscles, it does not treat the gap underneath the eyes which is the result of fat loss and muscle separation that occurs as we age. This is why a combination treatment using filler is often the best approach for improving the look of under eye bags.
Keir elaborates with a pro tip: “Using a combination of Botox and filler depends on a few factors: if someone has puffy bags under their eyes, you don’t want to use a filler that’s hydrophilic, or water-loving, because it’s going to attract water and appear more swollen. But if someone’s under eye area is really sunken in, it can be nice to use something that will puff the area up a little bit.”
Botox For Brow Lift
An important part of the eye area is the brows. For a less expensive, natural lift and a more youthful appearance, Keir recommends a Botox eyebrow lift. This targeted treatment lifts the center or the outer ends of the brow to achieve the popular “fox eye” look.
“The main indication for using Botox in the eye area is to treat crow’s feet,” Keir said, “But it can also smooth the brow area, and raise the brow, creating a youthful, alert effect, relieving that saggy, tired look that a lot of us get.”
Botox for Hooded Eyes
Botox for hooded eyes? Keir says yes! Just proceed carefully. This is one procedure where it is important to ensure you’re seeing an experienced injector, she recommends.
“The injector must be able to isolate which muscles are doing what, because Botox works as a paradox,” Keir said. “If you want to get a lift, you inject a depressor. Some of the muscles overlap, so you have to be careful.”
She added, “Often I use a two-step process where I treat the forehead area and glabella without focusing on the outside area or the brow lift. Then after two weeks, I’ll have the patient come back so we can effectively isolate those muscles that raise the brow to get the best results.”
Are You a Candidate?
Are you a candidate for eye area Botox? Book a consultation with one of Portrait’s expert providers today!
Is Botox around the eyes right for everyone? According to Keir, most people in their late twenties and early thirties are good candidates for Botox to treat crow’s feet. However, she emphasizes that it’s never too late to start and that the benefits are cumulative. With consistent treatment, it is possible to retrain the muscles to move less. This approach can improve the appearance of wrinkles and fine lines over time.
“I would say, anybody who's getting fine lines etched, meaning when you smile and create those lines, the lines remain after you stop smiling, should start using Botox,” Keir explained. “It’s like folding a piece of paper and unfolding it, that crease is still going to be in the center. If you see that crease that means you are breaking down the skin, so it is time to start using a neurotoxin (Botox, Dysport, or Xeomin) if you don’t want those lines to be permanent.”
How Many Units of Botox
When starting out, Keir generally recommends using 8-12 units of Botox per side.
How Long do Results Last?
According to Keir, a full treatment for crow’s feet with Botox around the eyes can have lasting results up to three months. To maintain results, she recommends consistent full treatments. Since we tend to smile and move the facial muscles a lot, regular upkeep is necessary for long-term reduction of etched lines or wrinkles.
Expert tips for Injectors
A common concern of patients and injectors alike is bruising, so Keir recommends using a very small needle. She also stresses the importance of a thorough assessment.
“Before I inject I have patients make a lot of dynamic movements to really see where their crow’s feet are and where their muscle strength is,” Keir said. “I don't only have them smile, I have them close their eyes and squint as hard as they can so I can address the whole lid, brow, and eye area.”
She added that you can also opt for a “Micro Botox” treatment below the eye to smooth superficial fine lines. Though she cautions that too much Botox can cause the cheeks to drop and notes that it is important for practitioners to be mindful and avoid over-injecting.
Injecting Pitfalls to Avoid
For new injectors, only inject up to the midline of the pupil when treating the eyes and avoid over injecting the crow’s feet as it may also affect the cheek area.
“You really have to look for blood vessels, so make sure your lighting is really good,” Keir advises. “Also make sure you assess for asymmetry because the eyes are often asymmetric, especially on the left side where you have a lot of photoaging on your driver's side (we’ve been driving since we were 16!).”
Keir added that it’s important to know your limitations: If a client is not a good candidate for a brow lift for example, proceeding anyway could cause lid-ptosis or drooping of the lids. She emphasizes that educating your clients and setting realistic expectations are important.
Second only to the glabella and forehead area, the eye area, specifically crow’s feet, is among the most popular areas for Botox treatment.
Keir comments, “It’s super preventative. Besides our necks and the back of our hands, the skin around our eyes gives away our age quickly.” Keir notes, “So many people are interested in make-up application now, so for them, it’s important to treat the eye area so their makeup doesn’t settle in the creases. With the popularity of microblading and how full brows are so in style right now, the eyes really have become a focus.”
Keir left us with the message that it is important as injectors to keep up with current beauty trends in order to know what clients are looking for - a wise bit of advice that will never go out of style.
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