Cosmetic Eye Treatments: Botox & IPL

Botulinum toxin injections

Botulinum toxin is what everyone knows as Botox, one of the most popular cosmetic eye treatments. It is used to smooth expression lines, mainly in the area between the eyebrows, on the forehead and around the eyes. This method, now widely used throughout the world, gives very good results with minimal complications and allows us to improve the appearance of mainly the upper part of the face in just a few minutes and almost without pain. The effect usually lasts 3 to 4 months, although the first few times a person has the treatment it often lasts longer.

Page contents

1. Botulinum toxin injections
2. Intense Pulsed Light (IPL)
3. Who is IPL for the eyes suitable for?
4. What to expect after Botox
5. Why have cosmetic treatments around the eyes with an ophthalmologist
6. Botox around the eyes: which wrinkles can be treated
7. Botox for medical reasons too
8. How Botox treatment is carried out step by step
9. Instructions before and after Botox
10. Possible side effects of Botox
11. IPL for dry eye: how it works
12. Who IPL is not suitable for
13. After an IPL session
14. Botox, IPL or blepharoplasty?
15. How often treatments are repeated
16. Safety and quality: what to ask
17. Why wrinkles appear around the eyes
18. Dark circles and eye bags: what really helps
19. Botox myths and facts
20. Daily care for healthy, rested eyes
21. Your first visit for a cosmetic assessment
22. Practice and patient: a relationship of trust
23. Frequently Asked Questions about Botox and IPL

Intense Pulsed Light (IPL)

The second treatment uses IPL. IPL is a device that uses intense pulsed light and can improve the quality and texture of the skin. This intense light delivers large amounts of energy to the darker areas of the skin, which are usually the ones we want to treat for cosmetic reasons, so that they are replaced by healthy tissue. The rest of the skin is protected by the head of the device, which is cooled, and by a gel similar to the one used for ultrasound scans, which also lowers the temperature of the skin.

This device has been used for years for facial rejuvenation, but in recent years another very useful application has become known. Patients with dry eye and blepharitis who had undergone this treatment noticed that their symptoms were significantly better afterwards. The same conclusion came from their eye examination, which showed that there was also an anatomical improvement in their condition. As a result, IPL treatment is now considered one of the options available for managing blepharitis, which is further proof of its effectiveness.

Who is IPL for the eyes suitable for?

IPL (Intense Pulsed Light) is used in ophthalmology mainly for meibomian gland dysfunction, the most common cause of evaporative dry eye. The light pulses are applied to the skin below the eyes, with the eyes protected by special shields. They reduce the dilated blood vessels that sustain inflammation along the eyelid margin and warm the glands so that their secretion flows more easily.

IPL may benefit people who have:

• meibomian gland dysfunction with burning, a gritty feeling and tired eyes,
• chronic blepharitis that is not controlled by eyelid hygiene alone,
• facial rosacea affecting the eyes,
• recurrent chalazia.

Usually 3-4 sessions are needed, 2-4 weeks apart, often combined with gland expression, followed later by maintenance sessions. It is not suitable for very dark or recently tanned skin, for people taking medicines that cause photosensitivity, or for certain skin conditions. Suitability is decided after a full examination for dry eye.

What to expect after Botox

Botulinum toxin (Botox) injections are given with a very fine needle and take a few minutes. You can return to your activities straight away, with a few simple precautions.

• In the first few hours: small red marks or slight swelling at the injection sites, which usually settle quickly. Less often a small bruise appears.
• In the first 24 hours: do not rub or massage the area, avoid strenuous exercise and saunas, and do not lie down for a few hours after the injection.
• After 3-5 days: the result starts to show and is complete in about two weeks. This is also when any small touch-up is assessed.
• Duration: the result usually lasts 3-4 months, and the muscles gradually recover.

Rarely, a temporary drooping of the eyebrow or eyelid, asymmetry or headache may occur. Contact the practice if you develop double vision, marked eyelid drooping or difficulty closing your eye. When the problem is loose eyelid skin, which Botox cannot correct, the solution is blepharoplasty.

Why have cosmetic treatments around the eyes with an ophthalmologist

The area around the eyes is one of the most delicate parts of the face. The skin is thin, the muscles that open and close the eyelids lie just underneath, and the eyeball itself is only a few millimetres away. Incorrect placement, or a light device used without proper protection, can affect the eyelid or the eye itself.

An ophthalmologist has an in-depth knowledge of eyelid anatomy and can examine the eye before any treatment: whether there is dry eye, a drooping eyelid, blepharitis or another problem that changes the way the treatment should be done. This way, cosmetic improvement never comes at the expense of eye health.

Botox around the eyes: which wrinkles can be treated

Botulinum toxin temporarily relaxes the muscles that create expression lines. It does not “fill” the skin, but stops the repeated contraction that etches the line. The areas treated most often are:

• Crow’s feet: the fine lines at the outer corners of the eyes, which deepen when you smile.
• Frown lines: the vertical lines between the eyebrows, which give a stern or tired expression.
• Forehead: the horizontal lines, with careful dosing so that the eyebrows do not feel “heavy”.
• Brow tail lift: a small technique that subtly opens up the eyes.

The aim is a natural result: a rested face that keeps its expression, without the “frozen” look that many people fear.

Botox for medical reasons too

Botulinum toxin is not only a cosmetic treatment. In ophthalmology it is the treatment of choice for blepharospasm, where the eyelids close involuntarily and repeatedly, and for hemifacial spasm, where one side of the face contracts. It is also used in selected cases of strabismus. In these conditions, treatment significantly improves quality of life and is repeated at intervals.

How Botox treatment is carried out step by step

1. Assessment: We examine the wrinkles at rest and in movement, the position of the eyebrows and eyelids, and discuss what you would like to change.
2. Planning: The injection points and the dose for each are marked, according to the strength of your muscles.
3. Injection: A few small injections are given with a very fine needle. Discomfort is minimal and the procedure takes 10 to 15 minutes.
4. Result: It starts to show in 3 to 5 days and is complete in about 2 weeks.
5. Review: At 2 weeks a small top-up can be given if needed.

Instructions before and after Botox

For a few days beforehand, if your doctor allows it, avoid aspirin and supplements that increase the chance of bruising, such as high-dose omega-3. After treatment, stay upright for the next 4 hours and do not rub or press the area. On the same day, avoid strenuous exercise, saunas and facial massage. You can go straight back to work.

Possible side effects of Botox

When the treatment is done correctly, side effects are rare and temporary. There may be a small bruise at the injection site, a mild headache on the first day or a feeling of heaviness in the forehead. Less often, the toxin affects the muscle that lifts the eyelid and causes a slight, temporary droop, which settles within a few weeks. Precise knowledge of the anatomy significantly reduces this risk.

Botox is not given during pregnancy or breastfeeding, when there is an active infection in the area, or in certain neuromuscular diseases. That is why your medical history is always discussed before treatment.

IPL for dry eye: how it works

The most important use of IPL in ophthalmology is not cosmetic. In meibomian gland dysfunction, the most common cause of dry eye, the glands of the eyelids produce thick oil that does not spread over the tears. The tears evaporate quickly and the eyes sting, turn red and tire easily.

The light pulses are applied to the skin below the eyes and on the cheeks, while the eyes are fully protected with special shields. The light gently warms the area, liquefies the oil in the glands and closes the small dilated blood vessels that feed the inflammation. After the treatment, the glands are often expressed to empty them of the thick secretion.

How many sessions are needed

Usually 3 to 4 sessions are recommended, 2 to 4 weeks apart. Many patients feel a difference from the second session. Because gland dysfunction is a chronic condition, a maintenance session every 6 to 12 months helps maintain the result.

Who benefits most

• People with evaporative dry eye who do not improve enough with artificial tears
• People with rosacea on the face and eyelids
• People with recurrent chalazia and styes
• Contact lens wearers who cannot tolerate them for many hours because of dryness

Who IPL is not suitable for

IPL is not used on very dark skin phototypes, on recently tanned skin, during pregnancy or in people taking medicines that cause photosensitivity. Care is also needed in people with a history of facial herpes. Assessment of the skin and the eye before the first session is essential.

After an IPL session

Immediately afterwards the skin may be slightly red or warm, like mild sunburn, which settles within a few hours. Protect the area from the sun with high-factor sunscreen for at least two weeks. Continue eyelid hygiene and artificial tears as recommended, because IPL works best as part of a complete treatment programme.

Botox, IPL or blepharoplasty?

Each treatment addresses a different problem. Botox treats wrinkles caused by muscle movement. IPL improves skin texture and treats gland dysfunction and dry eye. Blepharoplasty removes excess skin and fat when the eyelids have become “heavy” or bags appear. Often the best approach is a combination, in the right order and with the right timing.

How often treatments are repeated

No result on the skin is permanent, because time keeps moving. Botox is usually repeated every 3 to 6 months. With repeated treatments, many people notice that the result lasts longer, because the muscles “lose the habit” of strong contraction. After the initial sessions, IPL usually needs one or two maintenance sessions a year, depending on dry eye symptoms and the condition of the skin.

A planned schedule, with appointments before the result has completely worn off, gives a more consistent and natural appearance than occasional treatments. At each visit we adjust the doses and injection points according to how your face responded last time.

Safety and quality: what to ask

Before any cosmetic treatment, ask which product will be used, whether it is approved and sealed, and who will carry out the treatment. For IPL, ask whether your eyes will be protected with special shields and whether your skin phototype has been assessed. A doctor who answers clearly and also explains the limitations is the best sign that you are in safe hands.

Why wrinkles appear around the eyes

The skin of the eyelids is the thinnest on the body and has few sebaceous glands, so it dries out easily. Every day we blink thousands of times, smile, and squint in the sun or in front of a screen. Over the years, collagen and elastin decrease, and the lines from movement remain even when the face is relaxed.

Ultraviolet radiation is the biggest external accelerator. It is followed by smoking, lack of sleep, dehydration and the habit of rubbing the eyes. Also, when vision is not properly corrected, many people unconsciously squint to see better, which deepens the lines between the eyebrows and at the corners of the eyes. A simple eye examination and the right glasses help here too.

Dark circles and eye bags: what really helps

Dark circles have different causes. They may be due to inherited skin pigmentation, to thin translucent skin that lets the blood vessels show through, or to a shadow created by the hollow under the eye. Eye bags, on the other hand, are usually caused by fat that bulges forward as the tissues holding it in place loosen.

Pigmentation improves with light treatments such as IPL and with proper sun protection. Bags caused by fat do not go away with creams or massage; the definitive solution is lower eyelid blepharoplasty. When the bags change a lot from day to day or come with swelling and redness, they may be due to allergy, fluid retention or eyelid inflammation, and a medical assessment is needed first.

Botox myths and facts

• “Botox freezes the face.” With the right dose, the muscles relax but are not immobilised. Your expression remains natural.
• “If I stop, the wrinkles will get worse.” No. When the effect wears off, the muscles return to their previous function. The face does not age faster.
• “Botox is only for older people.” It is also used preventively in younger people with strong muscle activity, always sparingly.
• “It builds up in the body.” The dose for cosmetic use is very small and acts only locally, at the injection site.

Daily care for healthy, rested eyes

• Sunscreen suitable for the eye area and sunglasses with a certified UV filter all year round.
• Gentle make-up removal every evening, without rubbing.
• Warm compresses and eyelid cleansing if you are prone to dry eye or blepharitis.
• Screen breaks: every 20 minutes, look at something far away for 20 seconds.
• Enough sleep, good hydration and stopping smoking.

Your first visit for a cosmetic assessment

At the first appointment we discuss what bothers you when you look in the mirror, examine the eyelids, the skin and the surface of the eye, and explain honestly what each treatment can and cannot achieve. If a problem such as dry eye or blepharitis needs to be treated first, we do that before any cosmetic treatment. The treatment can often be done on the same day. To book an appointment, call +30 210 677 0007.

Practice and patient: a relationship of trust

Cosmetic treatments around the eyes give the best results when they are done gradually, in moderation and by a doctor who knows you. We keep photographs and notes from each treatment, so that every following session builds on what worked best for you. We never recommend treatments you do not need, and often the right answer is less intervention, not more. The aim is for you to look rested and natural, not different. If you have questions or would like to book an assessment, call +30 210 677 0007.

Frequently Asked Questions about Botox and IPL

Medically reviewed by: Dr. Vasileios Skouteris MD, FEBO