Which procedure would help minimize the appearance of creasing under eyes when smiling? (photos)

Hi from Istanbul, thanks for sharing your pictures. The procedure that could help minimize that creasing is a lower blepharoplasty. The removal of the fat pads, muscle tightening, and a very small excision of the skin, followed by skin redraping would enhance the under-eye area for a smoother appearance. Best of luck to you!

The structure you're pointing to is the tear trough/orbicularis retaining ligament. Just above this is orbital fat. This fat is what is responsible for the bags that we see as people age. Some people show fat this fat even when they are young. As this fat spills over the ligament, a sharp transition is seen between the lower eyelid and cheek, thus creating the crease you are experiencing. In your case, I think a lower blepharoplasty would be the best option to treat this with the goal being to smooth the transition between the lower eyelids and cheeks.

It looks like you have excess fat that can be transposed to mask the crease that is generated when smiling.

Best Wishes,

Gary Horndeski, M.D.