Periocular Botox in Turkey

Periocular Botox (Medical and Aesthetic Eye Botox)

What Is Botox?

Botox Is a Safe and Effective Treatment with a Strong Scientific Foundation When Performed by Experienced Hands

Botox takes its name from a toxin produced by the bacterium Clostridium botulinum, which can grow in improperly stored food. However, the form used in medicine today has been transformed from a powerful biological toxin into a controlled and safe therapeutic tool.

The foundation of this transformation is deeply rooted in ophthalmology.

In the 1960s, ophthalmologist and oculoplastic surgeon Alan Scott began investigating this toxin for the treatment of involuntary contractions of the muscles around the eyes and for strabismus (eye misalignment).

The goal was to temporarily weaken overactive muscles. After years of research and clinical studies, this approach became the foundation of modern Botox therapy.

Today, Botox remains one of the most effective—and often the only effective—treatment options for conditions such as:

Benign Essential Blepharospasm
Hemifacial Spasm
Meige Syndrome
Ocular Apraxia

In addition to its medical applications, Botox is also widely used in aesthetic medicine to reduce dynamic wrinkles around the eyes and create a more refreshed, youthful appearance.

The Transition to Aesthetic Use: A Discovery Born from Clinical Observation

The aesthetic use of Botox was not the result of a planned discovery but rather emerged from careful clinical observation.

The process began when physicians noticed that wrinkles on the side of the face treated with Botox for facial muscle spasms became significantly less noticeable over time. What initially appeared to be a minor observation actually revealed an important principle: when muscle activity is reduced, the overlying skin is protected from the repetitive movements that contribute to aging and wrinkle formation.

This observation was systematically investigated by Dr. Jean Carruthers, a dermatologist, and Dr. Alastair Carruthers, an oculoplastic surgeon. Through years of clinical research, they confirmed this effect and established a scientific foundation for the aesthetic use of Botox.

Today, with nearly 50 years of medical experience and more than 35 years of aesthetic use, Botox is recognized as one of the most thoroughly studied and well-defined treatments in terms of both safety and effectiveness.

The Medical Power of Botox: More Than an Aesthetic Procedure

One of the most important aspects of Botox is that it is far more than a cosmetic treatment.

In addition to treating disorders around the eyes, Botox is now widely used in the management of numerous medical conditions, including:

Chronic migraine
Excessive sweating (hyperhidrosis)
Teeth grinding and clenching (bruxism)
Masseter muscle hypertrophy
Bladder muscle disorders and urinary incontinence
Cervical dystonia and muscle spasms

This broad range of applications demonstrates that Botox is a powerful and reliable therapeutic agent that acts on the neuromuscular system.

Long-Term Safety of Botox: Evidence from Academic Research

One of Botox’s greatest strengths is its well-established long-term safety profile.

In my own study involving patients who received regular Botox treatments for eyelid spasms for up to 20 years, we demonstrated that the treatment maintained its effectiveness over time and remained safe during long-term use (Clinical and Experimental Ophthalmology, 2014).

The global scientific literature consistently shows that:

The vast majority of side effects are mild and temporary.
The most common side effects include temporary asymmetry, mild eyelid drooping, and headache.
Systemic side effects are extremely rare.
Even the uncommon ocular complications, such as eyelid ptosis or double vision, typically resolve completely within 3–6 weeks.
When administered at appropriate doses, Botox does not cause permanent damage to the body.

For these reasons, when performed correctly and by experienced practitioners, Botox has an exceptionally high safety profile.

Licensed Botox Products in Turkey

Botox is not a single product, but a group of medicines.

The main botulinum toxin type A preparations licensed in Turkey are:

OnabotulinumtoxinA (Botox® Allergan)
AbobotulinumtoxinA (Dysport® Ipsen)
IncobotulinumtoxinA (Bocouture® Merz)
PrabotulinumtoxinA (Nabota® Daewoong)

Although these products belong to the same family:

Their unit equivalence is not identical
Their diffusion and clinical effect profiles may differ

For this reason, there is no one-to-one dose equivalence between different products.

It is particularly important to emphasize that unlicensed or counterfeit botulinum toxin products pose serious health risks.

Unlicensed or fake products are often sold on the black market at very low prices. Therefore, unusually cheap offers may be encountered in some clinics or unofficial settings.

Licensed and original products are supplied only through official distribution channels to licensed clinics, medical centers, and hospitals, and are tracked via official GLN numbers.

For your safety, always ensure that the product is opened in front of you and that it carries an official barcode.

How Does Botox Work?

Botox temporarily blocks the nerve signals that activate muscle contraction.

As a result:

Muscle overactivity is reduced
The skin above the muscle becomes less wrinkled
A smoother appearance gradually develops
Through its effect on sweat glands, the skin may appear fresher and more radiant

An important point: Botox is not a filler.

It does not create volume in the face
It does not cause puffiness
It only regulates muscle activity

What Can Be Done with Peri-Ocular Botox?

Periocular Botox is one of the most delicate and high-impact applications in facial aesthetics.

When properly planned, it can:

Soften crow’s feet lines
Balance and slightly elevate the eyebrow position
Create a more open and refreshed eye appearance
Reduce a tired facial expression
Correct asymmetries

With more advanced approaches, it is even possible to subtly reshape the upper third of the face.

Botox Is Not Applied the Same Way by Everyone

The outcome of Botox depends much more on the practitioner than on the product itself.

The periocular area:

Requires millimetric precision
Has highly complex muscular dynamics
Small mistakes can lead to significant differences

For this reason, Botox is not merely an injection procedure; it is a process that requires detailed anatomical knowledge and facial analysis. In every patient, muscle strength, facial expression habits, and the eyebrow–eyelid relationship are different. Therefore, the same dose of Botox can produce different results in different individuals.

What Is a Natural Botox Result?

One of the most common misconceptions about Botox is the fear of a “expressionless face.”

In reality:

Loss of facial expression is not the result of good treatment, but of incorrect application
With proper technique, facial expressions are preserved within a balanced range
Unwanted or excessive muscle activity is selectively reduced

In a successful treatment:

You look more rested
You appear more energetic
However, it is not obvious that you have had any procedure done

Can Botox Make Things Worse After It Wears Off?

One of the most frequently asked questions is: “Does the face become worse after stopping Botox?”

The answer is no.

When Botox wears off, muscle activity gradually returns to its previous level. However, during the period of reduced muscle movement, the skin is exposed to less mechanical stress, and wrinkle formation slows down.

Therefore, the outcome is not a worse appearance, but rather a skin condition that has experienced less aging over time.

Periocular Botox: Conclusion

Botox is a powerful therapeutic tool that has been safely used in medicine for decades. Its value is even greater when applied to delicate areas such as around the eyes.

However, the most important point to remember is this:

Botox may be a simple procedure, but performing it correctly requires significant expertise.

When the right product, proper planning, and an experienced physician come together, it is possible to achieve natural, balanced, and safe results.

Frequently Asked Questions About Periocular Botox

Can Botox be applied around the eyes?

Yes, Botox can be safely and commonly applied around the eyes. It is especially used to reduce wrinkles known as crow’s feet. The aim in this area is to decrease muscle activity and prevent the formation of dynamic expression lines. When applied with the correct dose and accurate anatomical targeting, a natural and dynamic appearance is preserved.

How many days does it take for Periocular Botox to work?

Periocular Botox usually starts to show its effect within 3–5 days. The full effect is typically achieved within 10–14 days. During this period, muscle activity gradually decreases and the appearance of wrinkles is significantly reduced. Clinical studies indicate that the response to botulinum toxin may vary depending on individual muscle activity.

What should be considered after Periocular Botox?

Keep the head upright for the first 4 hours
Do not massage the treated area
Avoid intense exercise for 24 hours
Sauna, Turkish bath, and hot showers are not recommended on the first day
Avoid lying face down on the first night
Do not apply eye makeup for at least 12 hours

These recommendations help ensure proper localization of botulinum toxin to the target muscles and reduce the risk of complications.

At what age can Botox be applied around the eyes?

Periocular Botox is generally recommended from the age of 25–30, when expression lines start to become more visible. However, age alone is not the determining factor. Muscle activity, genetic predisposition, and skin elasticity are more important considerations. The preventive Botox approach is especially used to delay the formation of wrinkles at an early stage.

Who gets peri-ocular Botox?

People who receive periocular Botox are usually individuals who want to reduce crow’s feet and achieve a more rested and youthful appearance. It is commonly performed in both women and men. Clinical observations show that properly dosed and regularly applied Botox can provide aesthetic improvement while preserving natural facial expressions.

Periocular Botox in Turkey Prices

The cost of periocular Botox varies depending on the number of units used, the treatment area, the physician’s experience, and the city where the clinic is located.

Scientific Studies of Altuğ Çetinkaya on Periocular Botox

Scientific Articles

Çetinkaya A. Cilt Yenileme-Botoks-Dolgu-Kök Hücre ve Son Teknolojik Kozmetik İşlemler. Gürdal C, editor. Oküloplastik Cerrahide Güncel Yaklaşımlar. Ankara: Türkiye Klinikleri; 2018. p.104-12.
Ababneh OH, Cetinkaya A, Kulwin DR. Long-term efficacy and safety of botulinum toxin a injections to treat blepharospasm and hemifacial spasm. Clin Experiment Ophthalmol 2014; 42:254-61.
Cetinkaya A, Brannan PA. What is new in the era of focal dystonia treatment? Botulinum injections and more. Curr Opinion Ophthalmol 2007; 18:424-429.

Invited Lectures

Çetinkaya A. [Practical Applications of Cosmetic Botox and Filler Treatments Around the Eyes]. Ankara Training & Research Hospital Department of Ophthalmology Grand Rounds 2026, February 19, Ankara.
Cetinkaya A. Periorbital Injection Remedies in Graves Orbitopathy. 32nd Congreso SECPOO, 7-9 June 2023, Tenerife, Spain.
Cetinkaya A. Chairperson in Session 2: Non-surgical rejuvenation. The Aesthetic Masterclass. Global Cosmetic Surgery 2020, July 5, India & USA worldwide webinar.
Cetinkaya A, Goldberg R, Gonzalez-Candial M, Kaynak P, Ozturker C, Yeniad B. Case presentations to the expert panel: how I perform periorbital skin rejuvenation with minimally invasive treatment tools. Turkish Ophthalmology Association Society of Oculoplastic and Reconstructive Surgery Aesthetic Eyelid Surgery and Periorbital Rejuvenation Video Course (Skills Transfer) 2019, May 18, Istanbul, Turkey.
Cetinkaya A. Cosmetic surgery- non-surgical options in the face including fine threads, focused ultrasound, radiofrequency. The US (+Turkish) perspective on botox and fillers. Nordic Ophthalmology Congress 2016, June 9-12, Aarhus, Denmark.
Çetinkaya A. Dolgu ve Botoks Komplikasyonları. Oküloplastik Cerrahi Komplikasyonları Paneli. TOD 45.Kış Sempozyumu, 19-21 Ocak 2024, Konya, Türkiye.
Çetinkaya A. Cilt Gençleştirme. Okülofasiyal Kozmetik Cerrahi Dışı Tedaviler Paneli. TOD 57. Ulusal Kongre, 8-12 Kasım 2023, Antalya, Türkiye.
Çetinkaya A. Cerrahi İstemeyen Vakalarda Mimimal Invaziv Perioküler Rejuvenasyon. Mini-konferans. Faceminima International, 8-10 Eylül 2023, İstanbul, Türkiye.
Çetinkaya A. Tüm Yüz Gençleştirme ve Güzelleştirme Olgu Tartışmaları. Faceminima International, 8-10 Eylül 2023, İstanbul, Türkiye.
Çetinkaya A. Cilt Yenileme Uygulamaları. Göz Çevresi Estetiğinde Yenilikler Paneli. TOD 44. Bahar Sempozyumu, 13-15 Mayıs 2022, İstanbul, Türkiye.
Çetinkaya A. Okülofasiyel Bölgede Cerrahi Dışı Estetik Tedavide İpuçları: Medikal Uygulamalar ve Cihazlar. TOD 55. Ulusal Kongresi, 3-7 Kasım 2021, Antalya, Türkiye.
Çetinkaya A. Olgularla Blefaroplastiye Eşlik Eden Cerrahi ve Cerrahi Dışı Uygulamalar. Oküloplastide Güncel Yaklaşımlar Paneli. TRIO toplantısı, 22-24 Ekim 2021, Antalya, Türkiye.
Çetinkaya A. Kurs Moderatörlüğü. Okülofasyal bölgede cerrahi-dışı estetik tedaviler. Sanal Beceri Aktarım Kursu 2021, 27 Haziran, TOD Online Beceri Aktarım Kursu.
Çetinkaya A. Pratik bölüm Eğitmenliği. Okülofasyal bölgede cerrahi-dışı estetik tedaviler: Periorbital kırışıklıklar, nörotoksin uygulamaları, okülofasyal yumuşak doku dolguları, periorbital ip askılama ve mezoterapi. Sanal Beceri Aktarım Kursu 2021, 27 Haziran, TOD Online Beceri Aktarım Kursu.
Çetinkaya A. Göz çevresi ve yüz gençleştirmede non-invaziv ve mikro-invaziv yeni teknolojiler. TOD Ulusal Kongre, 2020, 12 Aralık, Online Kongre.
Çetinkaya A. Göz Çevresine Kozmetik Olarak Botoks Uygulamaları. TOD Kış Sempozyumu 2020, 24-26 Ocak, Antalya.
Çetinkaya A. Olgularla Göz Çevresinde Gençleştirme İşlemleri. Perioküler Bölge Cerrahi Dışı Yöntemler. TOD Bursa Şubesi Aylık Bilimsel Toplantısı 2019, 27 Aralık, Eskişehir.
Kurs moderatörlüğü Pelin Kaynak, Altuğ Çetinkaya. Perioküler Kozmetik Yaklaşımlar: Botulinum Toksin ve Dolgu Uygulamaları. TOD Beceri Aktarım Kursu 2019, 5 Mayıs, İzmir.
Çetinkaya, A. Göz Çevresi Gençleştirme Yöntemleri: Cerrahi Dışı Diğer Yöntemler. TOD İstanbul Şubesi Gece Toplantısı, 18 Nisan 2019, İstanbul.
Kurs moderatörlüğü Pelin Kaynak, Altuğ Çetinkaya. Perioküler Kozmetik Yaklaşımlar: Botulinum Toksin ve Dolgu Uygulamaları. TOD Beceri Aktarım Kursu 2019, 24 Şubat, Bursa.
Çetinkaya A. Dolgu Maddelerinin Perioküler Gençleştirme Amaçlı Kullanımları (teorik eğitim). TOD Beceri Aktarım Kursu 2019, 24 Şubat, Bursa.
Çetinkaya A. Botulinum toksini kötü uygulama düzeltimi ve komplikasyon yönetimi, yüz felci ve asimetrilerin giderilmesi: Botulinum toksin uygulamaları kursu. Medikal Estetik Derneği (MESTDER) Yeterlilik Kursları Sempozyumu, 2018, 1 Aralık, Antalya.
Çetinkaya A. Botulinum toksini kötü uygulama düzeltimi ve komplikasyon yönetimi-Orta seviye: Botulinum toksin uygulamaları kursu. Medikal Estetik Derneği (MESTDER) Yeterlilik Kursları Sempozyumu, 2018, 30 Kasım, Antalya.
Kurs moderatörlüğü Pelin Kaynak, Altuğ Çetinkaya. Perioküler Kozmetik Yaklaşımlar: Botulinum Toksin ve Dolgu Uygulamaları. TOD Beceri Aktarım Kursu 2018, 2 Aralık.
Kurs moderatörlüğü Pelin Kaynak, Altuğ Çetinkaya. Perioküler Kozmetik Yaklaşımlar: Botulinum Toksin ve Dolgu Uygulamaları. TOD Beceri Aktarım Kursu 2018, 7 Ekim, İstanbul.

Conference Proceedings

Çetinkaya A, Ababneh OH, Kulwin DR. Benign esansiyel blefarospazm ve hemifasiyel spazm tedavisinde botulinum toksini uygulamasının uzun dönem etkinliği ve güvenirliğinin değerlendirilmesi. TOD 46. Ulusal Kongresi, 2012, 17-21 Ekim, Antalya.
Cetinkaya A, Ababneh O, Brannan PA, Kulwin DR. Botulinum toxin-A for the treatment of focal dystonias in an oculoplastic clinic: an average of 15 years follow-up. ESOPRS 2008, June 13-14, Lucerne, Switzerland.
Cetinkaya A, Ababneh O, Brannan PA, Kulwin DR. Safety and efficacy of botulinum toxin type-a injections after an average of 14 years. American Academy of Ophthalmology-Turkish American Ophthalmology Society Meeting 2007, November 10-13, New Orleans, USA.
Cetinkaya A, Ababneh O, Brannan PA, Kulwin DR. Long-term efficacy and safety of botulinum toxin injections. ARVO 2007, May 6-10, Fort Lauderdale, USA.

Book Chapter

Çetinkaya A. [Skin rejuvenation, botox, fillers, stem cell and latest technologic interventions]. Gürdal C, editor. Current Approaches in Oculoplastic Surgery. T Klin Oftalmol; 2018. p.104-12. ISBN: 978-975-9118-90-7.