The 411 on "Jelly Roll" Botox - A Treatment For Puffy Undereyes

Get the Full StoryA trip to your injector is more commonplace nowadays than seeing your dentist. Plus, you're more likely to look forward to fresh Botox than your bi-annual teeth cleaning. But did you know that if you inject a neuromodulator like Botox or Daxxify into one area of the face, facial harmony dictates you may want to inject it another to maintain overall balance?

One part of the face that sometimes disrupts facial harmony is your undereye area. While there are many topical products to treat dark circles, fine lines, or puffiness that just won't go away, your best line of defense might just be something called "jelly roll Botox."

A playful name if ever there was one, "Jelly roll" Botox targets the muscle under the eyes to reduce the bulging or roll that appears when smiling or squinting. "The bulge is due to muscle contraction rather than fat, and Botox helps relax the muscle for a smoother, more refreshed look," says double board-certified dermatologist Saami Khalifian, MD. "However, since it can diminish the effect of smiling with your eyes, some people don't like it."

The treatment is mildly controversial: it's off-label meaning it's not an officially approved use for Botox , the undereye area is super delicate, and incorrect placement and dosing can leave you with an undesired drooping effect. Read on to learn more about jelly roll Botox and if it's the right treatment for you.

Experts Featured in This Article

Saami Khalifian, MD, is a double board-certified dermatologist, founder of SOM Aesthetics and Medical Director of Allergan Medical Institute.

Julius Few, MD, a board-certified plastic surgeon and founder of Dr. Few Skincare.

What Is Jelly Roll Botox?

Jelly roll Botox treats the difficult undereye area that frustrates many of us, whether due to genetics or the natural aging process. "The 'jelly roll' area of the lower eyelid is anatomically called the pretarsal orbicularis oculi muscle, which is the area covering four to six mm of skin below the eyelashes. This muscle is just beneath the skin, but on top of the cartilage that gives the eyelids form and shape," says Julius Few, MD, a board-certified plastic surgeon.

This muscle aids in closure of the eye, and also adds shape to the margin of the lower eyelids. In some people, this area can be thicker, especially if it is hyperactive, such as if you chronically squint, and can cause fat to be more prominent in the lower eyelids, creating bags under the eyes.

The injection is placed just beneath the lower lash line, targeting the muscle. "I usually place one to two units a few millimeters below the lower lash line just lateral to the mid-pupillary line. This softens muscle contraction, reducing undereye wrinkles, fine lines, and creasing when smiling. The eyes can appear brighter, more open, and less tired without looking unnatural," says Dr. Khalifian. It's important to note that the area of injection is performed off-label, meaning that though it is safe in the right hands, it is not FDA-approved.

Jelly Roll Botox Cost

The cost of jelly roll Botox depends upon provider, geographic location, and the recommended dosage. Jelly roll Botox generally requires fewer units of Botox, which typically runs between 10 to 20 per unit.

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Who Is a Good Candidate For Jelly Roll Botox?

Good candidates for jelly roll Botox are those who notice a prominent undereye bulge when smiling and desire a subtle, smoothing effect without fillers or surgery. "Those with undereye hollowness, true fat pads, or existing lower eyelid laxity should avoid it, as relaxing the muscle too much can cause the undereye to appear looser," says Dr. Khalifian.

While Botox is a beloved injectable and part and parcel of an overall anti-aging routine, it's important to understand its limitations: "Jelly roll Botox won't fix true undereye bags, hollowness, or dark circles. If the issue is fat pads, Botox won't help. If it's hollowness, tear trough filler, lasers, RF microneedling, or PRF are better options. If muscle contraction is the primary cause of puffiness, a small dose can be effective. Jelly roll Botox only helps the subset of patients that get that thin roll of skin immediately under the lash line upon smiling," says Dr. Khalifian.

It's imperative to recognize that the undereye area is very delicate and incorrect placement or dosing can cause temporary eyelid drooping, a dead eye smile, or difficulty blinking. "I use jelly roll Botox selectively based on the patient's anatomy and after the discussion of the risks. I especially recommend being treated by an advanced practitioner, especially because of its off-label usage," says Dr. Khalifian.

Dr. Few also cautions against getting jelly roll Botox if you lack the ability to completely close your eyes, which can be due to conditions such as Bell's Palsy, or if you've had any previous eye surgeries.

How Long Does Jelly Roll Botox Last?

You can expect your jelly roll Botox to last around six weeks, which is slightly shorter than Botox in other areas, due to the "thinness of the muscle and the very low number of units delivered," says Dr. Khalifian. Though he says you can increase the dose to lengthen its effects, it will also increase the intensity, which can deliver favorable or unfavorable results depending upon the patient. "Most patients return every few months when it's time to do the rest of their Botox," he says. He also notes that consistent jelly roll Botox treatments over time can weaken the overactive muscle movement, making your results last longer even as the Botox wears off.

To help extend and enhance the results of your jelly roll Botox, Dr. Few recommends daily application of daily undereye SPF, such as Dr. Few's Rejuvenating Eye SPF 15 175 for people with undereye bags or dark circles, to smooth, brighten, and depuff. Additionally, products such as SkinMedica's TNS Eye Repair 106 and Alastin Restorative Eye Treatment 118 improve collagen production in the sensitive thin skin under the eyes.

Taryn Brooke is a beauty writer and editor born and bred in New York City who has been in digital media for over 10 years. She is a contributing beauty writer for PS, Allure, Byrdie, and Well Good.

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