What Would Be The Best Treatment To Reduce The Aging Signs/Wrinkles When I Smile Under My Eyes?

The wrinkling and bags aren't usually present unless I smile. I am 35.

Doctor Answers 4

Botox treatment may help under eye wrinkles when smiling

Generally, there are a few options to improve the appearance of the lower eyelids, eye bags, or dark circles. First option includes basic skin care, tretinoin, and/or chemical peels. This nonsurgical method helps improve the skin quality, reduce pigmentary changes, and improves overall appearance of the lower eyelid & cheek areas.

Second more advanced option is an injectable filler or fat to plump up the area. Fillers are made of material that is slowly removed over time. Hyaluronic acid facial fillers such as Restylane or Belotero have been used to help smooth this area. Facial fillers treatment is performed in the office vial local anesthesia and with long-lasting results.

The last option, and also the most aggressive, is eyelid plastic surgery. Cosmetic surgery of the lower eyelid may remove or reposition fat in the eye bag area, and possible remove some sagging skin. Plastic surgeons typically don't recommend cosmetic eyelid surgery in young patients as the first option. However, each patient is unique and circumstances may vary. Age alone is not a determining factor if a person is a cosmetic surgery candidate.

For patient who demonstrate wrinkles only on smiling, a small amount of Botox can help soften the signs of aging around the eye.

Only after a comprehensive evaluation can a specialist help determine appropriate options for you. Best of luck.

Dr. Chaboki

Washington DC Facial Plastic Surgeon
5.0 out of 5 stars 65 reviews

Improve lines under eyes

Thank you for asking about correcting lines under your eyes.

  • The photos show a combination of creases caused by the orbicularis oculi muscle, slight skin excess and slight fat bulging,
  • Start with Botox,
  • lower eyelid blepharoplasty will help the skin and fat bulging,
  • A lower lid TCA peel (or several) will help the skin if surgery has no appeal.
  • Best wishes.

Under Eye Treatments


From your pictures and based on your age, I would suggest a combination of non-invasive treatments. Start with Botox to lessen the fine lines in the crow's feet area. An option for under the eye is a chemical peel or light laser to tighten the skin non-surgically. Doing this kind of treatment in the winter is more ideal as you do not want to be overexposed to the sun following treatment. Lastly, I would suggest Sculptra to the cheeks which will replace a very small amount of volume loss in the area and subsequently reduce the excess appearance under the eyes. Good luck!

C. Andrew Salzberg, MD
Westchester Plastic Surgeon
5.0 out of 5 stars 40 reviews

Wrinkle reduction is the key word here.

You need some of these of these lines which tell people your smile is real.

I personally think that a combination of Botox and Restylane fillers are the way to go for someone with your issues.

I see that you live close to Columbus Ohio so I recommend that you consider seeing Jill Foster, M.D. in Columbus for these issues.

Kenneth D. Steinsapir, MD
Los Angeles Oculoplastic Surgeon
5.0 out of 5 stars 20 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.