Best Treatment for Dynamic Wrinkles?

asked 3 years ago by QueenBe
Latest answer by Raffy Karamanoukian, MD
Question viewed 4,399 times
Tags: under eyes, wrinkles, crease, dynamic

I'm desperately seeking some help for the deep lines or wrinkles that appear under eyes when I'm smiling. I don’t have the typical crow’s feet, just these deep lines under my eyes that appear when I smile. It's still visible when I'm not smiling, but not significant. Are there any treatments to address this problem, because I certainly don't want to stop smiling.

6 answers to Best Treatment for Dynamic Wrinkles?

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... more

Brent Moelleken, MD
Beverly Hills Plastic Surgeon

Botox and filler may be just the thing for you.

Botox alone can be useful for dynamic rhytids of the lower eyelids. Loss of fat in the tear trough/lower eyelid region can also make the wrinkles of the lower eyelids appear more prominent in which case you might also benefit from a small volume of filler (e.g. restylane). Good luck.

Bryan K. Chen, MD
San Diego Dermatologist

Botox, fillers or skin resurfacing

Dynamic wrinkles are usually caused by muscle contraction. However, there is an underlying skin excess as well. Botox works on relaxing the muscles and could help to eliminate some of these wrinkles that exist on the outside of the eye (crow feet) As a general rule, I do not like to inject Botox too close to the lower lid or beyond the iris (color of the eye). Injecting Botox too close to the eyelid could weaken the muscle in this area (temporary). A combination of Botox and skin... more

Hisham Seify, MD, PhD
Los Angeles Plastic Surgeon

Botox Treatment for Crow's Feet and Undereye Wrinkles

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... more

Raffy Karamanoukian, MD
Los Angeles Plastic Surgeon

Dynamic Wrinkles=Botox

For the dynamic portion of your lower eyelid, a small amount of concentrated botulinum toxin can be effective. As mentioned in previous post, botulinum toxin can deactivate a portion of the orbicularis oculi muscle. This muscle helps in providing tone to the lower eyelid. Your doctor should assess the strength and integrity of the lower eyelid prior to placement of botox toxin. A lid with poor tone can be pulled down with botox therapy creating a hounddog look aka ectropion. For other... more

Anil R. Shah, MD
Chicago Facial Plastic Surgeon

Keep smiling

Your lines are from a combination of smiling and sun exposure. Dynamic lines in the lower lid are impossible to eliminate completely and any treatment will not prevent recurrence as long as the muscles are being used for smiling and squinting. So if your goal is a slight softening of these lines, go ahead with Botox and possibly Restylane. But if you want no wrinkles, that can't be achieved and it would be best to save your money and just keep smiling.

Richard P. Rand, MD, FACS
Seattle Plastic Surgeon

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