Wrinkles under eyes when smiling? (Photos)

I am 42 and when I smile i get a bunching up of skin under my eyes and when I don't smile this doesn't happen. It really ages me. What can I do to help this? Thanks

Doctor Answers 5

Treatment for Wrinkles Around Eyes

Hi and thank you for your question! The skin around the eye area is thin and prone to lines and wrinkles. I agree that a neuromodulator (such as botox or disport) would be ideal to help these lines. Also, consider starting laser treatments to repair the collagen in the area. We like the Venus Viva because it can treat very closely to the under eye area. Best, Dr. Grant Stevens


Los Angeles Plastic Surgeon
4.8 out of 5 stars 137 reviews

Lines Under the Eyes

Hi Simjul,
The photos look like simple case of dynamic lines caused by the contraction of the muscle that closes the eyes. The best solution for this is botox injection, however, it also seems from the photos that you have some tear trough (line under eye) which can be improved by filler injection.

Somyos Kunachak, MD
Thailand Facial Plastic Surgeon
4.8 out of 5 stars 16 reviews

Treatment for lines under the eye.

Hello!  Under eye wrinkles are a very common concern.  The reason for this is simple:  Generally speaking, there are 3 processes which lead to facial aging. (1) muscle contraction, primarily in the upper face, can cause expression lines to be come etched into the skin.  (2) volume loss along the cheek bones can lead to hollowing under the eyes, and lines of the lower face.  (3)   The skin itself becomes weak and  stretchy with time due to loss of collagen.  Underneath the eye all 3 of these things come together to create the perfect storm.  Therefore, non invasive treatment for under eye wrinkles can be complicated. I do not see volume loss under your eyes yet - so I would not do fillers. Botox can be used  around the corner of the eye, as well as directly underneath the eye.  This will help you the most - the majority of those lines appear muscular to me based on your pictures. The other option for you is to do a series of treatments to stimulate the skin to grow more collagen, so that it has the ability to stand up to gravity better, which will reduce those lines.  Skin can regrow collagen, but only when it thinks that it has been wounded.  Therefore, all collagen increasing treatments are based on the concept of the controlled wound.  You do something to the skin, create some small amount of damage, and the skin responds by growing more collagen.  Lasers use heat to create this controlled wound, peels use acids, and microneedling uses physical puncture, however, they are all "getting at" the same healing response.  For under eye line such as yours, I would recommend Botox, followed by a series of Microneedling if the Botox treatment does not give you the result that you want.

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Under Eye Wrinkles

Thank you for your question and we understand your concerns.  We recommend you find an experienced physician in your local market.  You would probably benefit from a combination approach based on your needs and budget.  After a complete consultation, we normally recommend various options from physician grade products, BOTOX/XEOMIN, filler and possible lasers.  It really depends your needs, concerns and budget.  It may be as simple as BOTOX/XEOMIN injections every 3-6 months and ALWAYS wear a quality sunscreen.

Laura Riehm, MD
Fort Worth Physician
5.0 out of 5 stars 1 review

Eye wrinkles when smiling

You could use some Botox to the crows feet to improve this. If you still have more than you want, filler in the area with Restylane would also help. I use cannulas for this to improve safety and decrease bruising.

Steven F. Weiner, MD
Panama City Facial Plastic Surgeon
4.6 out of 5 stars 27 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.