Everything You Need to Know About Jelly Roll Botox, the Viral Treatment that Promises Smoother-Looking Under-Eyes
Plus, why it's currently going viral on TikTok.
If every time you doom scroll your feed, there seems to be a new way to use Botox, it’s because there is. Whether it to smooth your neck's platysmal bands (also known as a “Nefertiti lift”) or to slim an over-defined masseter muscle in your jaw, the options seem endless. For years, Botox and other neuromodulators, including Dysport, Daxxify, Juveau, Xeomin, and Letybo, have been used both on- and off-label, meaning not in accordance with the FDA guidelines, but still generally considered safe and effective by trained providers. One of the most of-the-moment off-label uses is “jelly roll Botox”, which reduces the small bulge of skin under the eyes when you smile or squint.
But why is jelly roll Botox suddenly the treatment du jour? According to board-certified facial plastic and reconstructive surgeon Kimberly Lee, MD, it signifies the growing trend of “tweakments” and further solidifies a cultural shift towards subtle, undetectable results. Framed as a quick fix for treating under-eye puffiness, jelly roll Botox is the perfect model of a nonsurgical treatment that offers a lot of bang for your buck.
In an era where selfies and the back camera rule, it comes as no surprise that more people are jumping on the jelly roll Botox train for smoother, more youthful-looking eyes. If you’re considering jelly roll Botox but aren’t sure if it’s right for you, you’ve come to the right place. Ahead, find everything you need to know before undergoing jelly roll Botox at your next aesthetics appointment.
What Is Jelly Roll Botox?
Jelly roll Botox is an off-label treatment that relies on any one of the six FDA-approved neuromodulators to soften small pockets of puffy fullness (aka the jelly roll) under the lower eyes that form when smiling. These bulges occur when the orbicularis oculi muscle contracts, and treating the muscle causes a reduction in the hyperactivity of the muscle directly under the eyelid, says board-certified plastic surgeon John Layke, DO. Injecting just a small amount of neuromodulator is all it takes to halt communication between the nerves and muscle, temporarily relaxing it so that the roll of skin appears smooth.
Despite the social media push that’s putting jelly roll Botox front and center, physicians have relied on this off-label technique for decades, says board-certified dermatologist Derek Jones, MD. Botox, which was FDA approved in 1989 to treat blepharospasm (spontaneous eyelid muscle contractions), had a side effect that ophthalmologist and Botox pioneer Jean Carruthers, MD, and her late dermatologist husband, Alastair Carruthers, MD, noticed. “Her blepharospasm patients saw wrinkle-effacing effects around the eyes,” says Dr. Jones. From there, it became the gold standard wrinkle reducer.
(L to R): A patient before and after receiving jelly roll Botox injections.
Who Is a Good Candidate for Jelly Roll Botox?
Before you run to your doctor asking for jelly roll Botox, you need to make sure you’re a good candidate for the treatment. Rule number one is to determine whether your under-eye concerns are caused by herniated fat bags, which result from volume loss and weak ligaments, loose skin, or muscle contraction, all of which require completely different treatments. (Don’t worry—your doctor can help to identify all of this at a consultation appointment). “Botox will not fix pseudo-herniated, lower eyelid fat that presents itself as puffiness under the eyelid and above the tear trough,” says Dr. Layke. However, if a small bulge appears only when smiling, it is likely the result solely of muscle contraction and should respond well to the injections.
Good skin quality also matters. Your doctor can perform a simple snap test by pulling back the skin and quickly releasing it to assess how it retracts to evaluate its elasticity. “Often, younger patients respond best to this type of Botox treatment,” says Dr. Jones. “Older patients with lid laxity usually don’t.”
(Top to bottom): A patient before and after receiving jelly roll Botox injections.
What are the Main Benefits of Jelly Roll Botox?
Smoother, more youthful-looking eyes make jelly roll Botox a go-to, but there’s more to it than just that. While the treatment is quick and easy, Dr. Lee says it’s also easier to do than fillers or surgery. “Jelly roll Botox doesn’t add volume like filler, so there’s a decreased risk of overcorrection or lumpiness,” she explains. “Plus, compared to surgery, there’s minimal downtime and less potential for complications like scarring or infection, so it appeals to patients who seek subtle improvement without a big commitment or recovery.”
Another under-the-radar benefit is improved skin quality. Board-certified dermatologist Mara Dacso, MD, says treating the naturally thin skin under the eyes with a neuromodulator softens muscle contraction and improves elasticity and skin texture. “Minimal product is required to produce a noticeable effect,” she adds.
Will Jelly Roll Botox Fix My Dark Circles?
If you’re thinking that a bit of Botox will solve all your eye concerns, especially dark circles, I hate to break it to you but…it won’t. Dr. Lee says it’s not an effective treatment for pigment-related issues because neuromodulators only relax muscle movement—they don’t address discoloration, thinning skin, or vascular show-through. In some cases, a bit of Botox may make them appear slightly worse because of residual fluid buildup that accentuates shadows under the eyes. To treat dark under-eye circles, Dr. Dacso recommends lasers and dermal fillers as in-office options (or under-eye concealer in a pinch).
What Will My Eyes Look Like After Jelly Roll Botox?
It takes a few days to up to two weeks for the results to be fully noticeable, which largely depends on the neuromodulator used and the degree of muscle activity. “The more hyperactive the muscle, the more you’ll notice the results,” says Dr. Layke. Once the toxin kicks in, the jelly roll becomes less pronounced, and the skin appears almost filtered. Dr. Jones adds that it also widens the eye, reduces the look of fine and dynamic lines, and can improve asymmetric eyelids.
Although there’s still some movement in the area, the eyes retain a natural look. “A lot of patients with true jelly roll deformity are very happy with the results because the treatment makes the eyes look less tired,” adds Dr. Layke.
(L to R): A jelly roll Botox patient three weeks post-injections.
How Long Does Jelly Roll Botox Last?
On average, jelly roll Botox tends to last a little less than usual Botox done elsewhere on the face because of the small dose used. You can expect it to last six weeks to three months. Keep in mind that the results of jelly roll Botox aren’t permanent; it needs to be repeated every few months to maintain the results.
What Are the Risks of Jelly Roll Botox?
There are a few potential side effects with jelly roll Botox, and the more common yet easy-to-manage ones include temporary bruising (avoid blood thinners for seven to 10 days to reduce this), swelling, and redness. “If too much Botox is injected, the lower eyelid can droop and may turn outward, known as ectropion, exposing the inner surface and causing dry eye,” says Dr. Jones.
Another effect of heavy-handed injections? Lid lag and swelling from lymphatic disruption. “The lower eyelids can appear a little droopy if a poor technique is used or the neurotoxin is injected too deeply, causing unintended spread,” explains Dr. Dacso. This is why a conservative approach using minimal amounts of neuromodulator, and visiting a board-certified provider for the treatment, is best.
Even though jelly roll Botox is an off-label use, keep in mind that it’s not a one-size-fits-all solution for every under-eye concern. While Dr. Jones says that large-scale studies on the safety and effectiveness of this treatment have not been done, there are still plenty of reasons to consider it if it’s right for you. When in doubt, consult with an expert that you trust and who can answer all of your questions about the treatment.
Meet the Experts
Dr. Kimberly J. Lee is a facial plastic and reconstructive surgeon and the residing Director of the Beverly Hills Facial Plastic Surgery Center. She is an Assistant Clinical Professor in the Division of Head and Neck Surgery at Ronald Regan UCLA Medical Center, is an Attending Surgeon at Cedars-Sinai Medical Center, and serves on the Board of Governors at Stanford Medical Alumni Association. Dr. Lee is board-certified by the American Board of Otolaryngology/Head and Neck Surgery. Her surgical expertise lies in facial rejuvenation, facelifts, rhinoplasty, blepharoplasty, Asian blepharoplasty, ethnic plastic surgery, facial paralysis reconstruction, nasal reconstruction, and head and neck cancer reconstruction.
Dr. John Layke is a Diplomate of the American Board of Surgery as well as a Diplomate of the American Board of Plastic Surgery. He is not only an artist but an accomplished surgeon, scientist, and author. Dr. Layke has published several articles in reputable medical and surgical journals and presented at national and international conventions. He is currently an active member of the American Society of Plastic Surgeons. Dr. Layke has appeared on local news stations and national broadcasts. He is the Co-Founder of Beverly Hills MD, an internationally known skincare line that blends cutting-edge dermal technology and natural skin care ingredients to help replenish essential nutrients and reclaim lost youth from environmental damage.
Dr. Jones is a world-renowned aesthetic dermatologist and a widely published author with over 100 publications in leading peer-reviewed medical journals. He has written several textbook chapters, is editor of the acclaimed textbook Injectable Fillers: Principles and Practice (Wiley- Blackwell), and has served on the editorial boards of the Journal of Dermatologic Surgery, Aesthetic Surgery and Medicine, and Journal of Cosmetic and Laser Therapy. He is regularly featured as a dermatology expert on local and national television networks. He is a frequently invited speaker at prestigious dermatology meetings and has delivered over 300 scholarly lectures.
Dr. Mara Dacso is a recognized leader in dermatology. Dr. Dacso practices both cosmetic and general dermatology and is passionate about helping her patients achieve optimal skin health and natural results. She leads aesthetics at Innovative Dermatology and provides cutting-edge treatments, including injectables, lasers and devices, and regenerative therapies, to help her patients look and feel their best at every stage of life. She also has special expertise as a consulting pathologist for patients with Hansen’s disease (leprosy). Dr. Dacso holds leadership positions in the American Academy of Dermatology, the American Society of Dermatopathology, and the Texas Dermatological Society, and has presented her work at local and national meetings.
