Dynamic under eye wrinkles

Botox is the easist solution for dynamic wrinkles, that is wrinkles that occur only when the patient is animating.

For wrinkles elow the eye, your doctor should be careful not to be too aggressive. Why is aggressive Botox around the eye potentially bad?

Aggressive Botox below the eye deactivates the orbicularis, the circular muscle that surrounds the eye.  While it may effectively reduce wrinkles below the eye, it can cause the cheeks to droop, giving an odd, apple-like bunching when the patient smiles.  Also, the muscles that elevate the lip are close to the lower eyelid and can be inadvertently deactivated, causing the lip function to decrease, often asymmetrically.

When the problem becomes worse than what traditional Botox can handle, some patients consider a cheeklift.  There are many types of cheeklifts.  We prefer the LUSIC (LiveFill ultrashort incision cheeklift), which elevates the cheek tissue and supports the corner of the eye, preventing it from dragging down and rounding, as can occur with a treaditional lower eyelid blepharoplasty.  With this technique, the orbital septum, the dangerous layer which attaches to the lower eyelid and-- if scarring develops-- can drag it down, causing a change in eye shape, is avoided altogether.

This type of cheeklift allows some skin to be removed from the lower eyelid with an extremely low chance of altering its shape.

The result is the preservation of an almond shaped eye with some tightening of the lower eyelid skin, plus tightening of the outer portion of the orbicularis muscle, reducing the appearance of below the lower eyelid wrinkles, including dynamic wrinkles.  The eye-cheek junction is smoothened as well.

Some very fine doctors believe in augmentation of the cheeks as a method of enhancing cheek volume, and thereby filling in the lower eyelid-cheek junction, and this is something to discuss with your doctor as well, should the conversation come up.

But the simple answer is Botox.

Botox cosmetic is effective in the treatment of dynamic wrinkles associated with overactivity of the orbicularis oculi muscle.  In many cases, the lateral crow's feet are prominent as a result of soft tissue and skin atrophy, as well as overactive orbicularis muscles.

Rarely, the lower eyelid wrinkles can occur as a result of tissue discordance between the thick cheek skin and the thin eyelid skin. This results in wrinkling caused by the upward movement of the cheek while smiling.  Botox is not useful in this situation. 

Thus, it is advised to seek treatment with a board certified plastic surgeon to distinguish these two very specific situations and recommend the appropriate treatment.

1 of 1 found this helpful

Helpful?

Contact the doctor