What can be done about this pulling under my eyes when smiling? (Photos)

Hello! My name is Jessica, I am a physician assistant, and one of the providers at Aesthetic Skin - Winnetka & Chicago. This is a great question. Yes, the “pulling” or ridge you’re noticing under your eyes after years of Botox around the crow’s feet area is most likely related to how the orbicularis oculi muscle — the circular muscle that surrounds the eye — has adapted over time. When Botox is used repeatedly in the outer portion of this muscle (the lateral canthus), it weakens those fibers, and the untreated sections (particularly the lower or inner parts) can sometimes contract more strongly to compensate. This overactivity or imbalance can create a visible ridge, ripple, or feeling of tight pulling under the eye. In some cases, a very small, carefully placed micro-drops of Botox can help relax that specific overactive segment. I hope this helps!

Hi, thank you for sharing your photos and providing such a detailed description—it really helps clarify what’s happening. From what you’re describing, the pulling or ridge under your eyes when you smile is likely related to the orbicularis oculi muscle, which surrounds the eye and controls eyelid movement. When you smile, this muscle contracts, and in some people, it can create a slight ridge, tension, or pulling sensation in the lower eyelid or cheek area.

Here’s a bit more about why this might be happening:

Long-term Botox history: Since you’ve had Botox in your crow’s feet for many years, the surrounding muscles may have adapted. When you stopped, some of the under-eye muscles may be more noticeable or have slightly changed in tone, which can create a pulling effect.

Anatomical factors: The ridge you notice could also be influenced by natural variations in the orbital bone, fat pads, and skin thickness. These subtle structural features can become more prominent when muscles contract during a smile.

Treatment options:

Targeted Botox: Yes, a small, precise amount of Botox directly into the pulling area can help relax the overactive muscle and soften the ridge. It requires careful placement to avoid affecting normal eye function.

Adjunct options: In some cases, skin tightening treatments or filler can also help smooth the area, depending on the exact anatomy and your goals.

In summary, what you’re seeing is largely muscle-related, and a tiny, well-placed Botox injection could potentially calm it down. The slight improvement you’ve noticed after stopping Botox is consistent with muscle adaptation over time.