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

 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.

Thank you for your question and for sharing your photo. Botox may help to soften the wrinkles under the eyes. It does require a very small amount and it will help to soften the lines. It will not necessarily reduce all the wrinkles like you might see in the forehead or crows feet region. You will notice a soft relaxation of the dynamic lines under the eyes, and you may notice a slight opening of the eyes. I would start with 1-2 units under the eyes on each side. If you like the effects, then it is very easy to incorporate this into your future treatments. Dermal fillers such as Restylane can be used to fill in shadows under the eye and achieves a more rested look. You can combine the two treatments but it would require a thoughtful approach and careful analysis of your concerns to ensure that treatment options will help you achieve your goals.I would recommend visiting with a board certified plastic surgeon or dermatologist in your area to address your concern as it is an advanced area to treat.

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

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.

Gid Day ksg,

  You can have a few units of Botox properly placed to help your under ey smile wrinkles.  Choose your injector most carefully.  Good luck and be well.  Bee's knees!

Dr. P