Bunching Under Eyes When Smiling - Will Botox or Fillers Help? (photos)

Question

I am 30 years old and have noticed as I get older, the skin under my eyes tends to bunch up when smiling, which creates these lines and folds underneath. It also makes my eyes seem not every wide and they seem to be getting "smaller" as this gets worse. What can be done to combat this? Botox? Fillers?

Nima Shemirani, MD · Answer

Hi @infinitemeridian! A few units of botox can help with the wrinkles you experience with smiling. I also recommend a co2 laser to help tighten the skill.

Jason Emer, MD · Answer

The eye area needs significant combinations to get improvement. Lasers like erbium, co2, halo, profractional/contour, or Fraxel can all be used to build collagen long term. Plasma pen is a newer less invasive option but will take many treatments and require proper skincare. Plasma Pen is focused electrical plasma energy to tighten skin, producing small columns of energy just above the skin, allowing the skin to tighten to help improve wrinkles. This area will have 3-5 days of small “dots” that will then scab and peel, then the skin will tighter and brighter after. Numerous treatments are needed over lasers where only one or two give a bigger result, but more downtime. After plasma pen you NEED peels 2 weeks like later Cosmelan, enlighten or aerify, see emeragecosmetics (link). At home derma rolling should be started weekly even after plasma pen or lasers to further increase collagen, see emeragecosmetics AERIFY x anteagemd stem cell ampules. To properly heal you need light Stim red LED, EmerageSkin refit face, refit eye; AnteageMD serum, silagen silicone gel, jan Marini bioshield, EmerageSkin enzymatic polish, and EmerageSkin hyla b and AOX, and Sente dermal repair. Otherwise there is EXTREME risk of pigmentation issues and “dots” in the treatment area. at home peels like cosmelan, enlighten and aerify along with dermarolling (AERIFY emerageskin roller with Anteage MD ampules) should be started now regardless for antiaging, sun damage, and wrinkle prevention. There are many things you can do to treat under eye hollows and dark circles. A surgical option to remove skin and/or fat will such as eyelid blepharoplasty with or without fat pad repositioning (if doing lower eyelid surgery) will be the best long term. There are many things you can do to treat under eye hollows and dark circles without surgery. Non invasive less downtime options such as fillers, lasers, microneedling/PRP, cosmelan peels, and microneedling RF like Fractora, PiXel8 or morpheus can all help give some improvement. Accutite can often be used or stronger lasers like erbium or co2 spot treatment can tighten the skin and give very quick improvement in wrinkles and texture. I suggest you get a formal consultation to see what is best for you and your goals. Best, Dr. Emer.

Jonathan Kulbersh, MD · Answer

Thank you for submitting your question and photos. You would likely benefit from neuromodulator injections such as Botox or Dysport to smooth the skin around the eyes and address the bunching effect you describe. 
These formulas work by relaxing the muscles that cause a wrinkled appearance when making certain facial movements such as smiling. I recommend scheduling an in-person consultation with an experienced, board-certified injector who can assess your concern and recommend the best treatment for you.

Cory Bovenzi, MD · Answer

Hi and thanks for the question! The undereye area can be a tricky one due to the different modalities that are specific for the undereye area subtleties patients can see. In your case, I think a small dose of botox would help with the "jelly roll" you are seeing. I don't see any tear trough deformity that filler or surgery would be used for. Best of luck!

Keshini Parbhu, MD · Answer

A couple of units of neurotoxin like Botox can help under eye wrinkles that happen when smiling. Fillers would not really address this problem.

Bunching Under Eyes When Smiling - Will Botox or Fillers Help? (photos)

Answers (5)

Answer: Eye bunching

Answer: Eye bunching

Answer: Bunching under the eyes

Answer: Bunching under the eyes

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Bunching Under Eyes When Smiling - Will Botox or Fillers Help? (photos)

Answers (5)

Answer: Eye bunching

Answer: Eye bunching

Answer: Bunching under the eyes

Answer: Bunching under the eyes

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Recommended reading

Everything you need to know about Dermal Fillers

Our mission is to create a world where every investment in modern beauty is Worth It.