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Under Eye Wrinkles Caused By Smiling - Will Botox/Fillers Help?

Hi When i smile i get these horrible lines caused by my cheeks pushing up and causing a fold - they dissapear when i smile. How can i treat these? fillers/botox? anything?? i absolutely hate them and they are getting worse as i age. I am only 29. any advice would be fantastic thanks so much

Doctor Answers 19

Under eye fine lines

The fine lines that you are complaining about are from loose skin. It is best to remove the skin conservatively to soften this.

New York Plastic Surgeon
4.5 out of 5 stars 21 reviews

Lower lid creases

 You mentioned that the lower lid creases form when you smile and then you mention they go away when you smile, but you probably meant they go away when you stop smiling. There can be no guarantee but it's worth trying one to two units of Botox in the lower eyelid skin, just a couple of millimeters below the eyelash margin. the lid may change its shape and you may see some white of the eye below the iris.  lastly, if you have had preexisting puffiness in the eyelids, especially in the mornings when you wake up, then you shouldn't have Botox injected there as it will interfere with the muscular pump action and fluids may build up and  your swelling could look worse.

Ronald Shelton, MD
Manhattan Dermatologic Surgeon
5.0 out of 5 stars 33 reviews

Squinting and Smiling are two different things: like Yin and Yang

You are very accurate and precise in your description. Yes these can be caused by contraction of the eyelid muscles which people do when smiling and this can be weakened with Boulinum Toxin. However this can cause more fullness of the lower eyelid by relaxing the muscles similar to relaxing your stomach muscles causes a fuller appearing belly.

However, you also push skin up to the eyelid when smiling with the zygomatic muscles and this cannot be weakened unless you want to look like you have had a stroke.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
5.0 out of 5 stars 58 reviews

Help for eyelid wrinkles

Lower eyelid wrinkles can be reduced by proper placement of Botox or Dysport. In many people, Botox alone is sufficient.

However, the wrinkles come not only from muscle contraction, but also from loss of volume and decreased skin elasticity. Hydration of the delicate eyelid skin with an excellent moisturizer reduces wrinkles.

In many cases the loss of volume can be corrected with Restylane injections. Other patients may require a laser procedure to help improve the eyelid skin tone and texture.

David Schlessinger, MD
Long Island Oculoplastic Surgeon
4.5 out of 5 stars 13 reviews

Smiles and wrinkles under your eyes may improve with a touch of botox...

but the improvement is relatively only need 1-2 units of botox in 1 or possibly 2 sites...just a little bit under your lid some people a great benefit...most with some benefit...some especially in an older age group with weaker muscles...typically in the 50+ age group actually may be conservative...a filler is typically not for this problem...but remember your skin will always crease somewhere when you smile...

Ken Landow, MD
Las Vegas Dermatologist
4.5 out of 5 stars 9 reviews

Botox of fillers for under the eyes

  I think Botox might be beneficial here.  But I also agree that a conservative skin only lower eyelid surgery might provide lasting improvement.

Lawrence Kass, MD
Saint Petersburg Oculoplastic Surgeon
5.0 out of 5 stars 84 reviews

Botox for under eye creases~less can be best

For the problem you're describing just a little bit of Botox properly placed in that lower eyelid area can make a big difference.  A slight bit of filler in the hollows under the eyes can also help to smooth the appearance.  And last but not least, don't under estimate proper hydration with a good eye cream in that area....dehydrated skin can bunch up and look horribly wrinkly.


Grant Stevens, MD
Los Angeles Plastic Surgeon
4.5 out of 5 stars 94 reviews

Botox helps with lower lid lines

Botox can soften lower lid lines. Your doctor should put emphasis on giving you a natural appearance. 

Robert Kasten, MD
Mainz Dermatologic Surgeon

Go with Botox

Go with Botox. These are dynamic wrinkles (present with smiling and go away without smiling). This is the classic reason Botox helps. Do NOT use a filler (better for VOLUME loss issues). Make sure you go see either a Dermatologist or plastic surgeon, as this can be tricky area to inject.

Tracy Kuykendall, MD
Tulsa Dermatologist
4.0 out of 5 stars 5 reviews

Under Eye Wrinkles Caused By Smiling - Will Botox/Fillers Help?

Thanks for posting a photo. The answer is worth a try. Seek a boarded injecting doctor in the "land downunder". From MIAMI Dr. Darryl j. Blinski

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