How to fix bunching/cheek pushing up excess skin under eyes when smiling? (Photo)

For unique cases where a variety of modalities could be used to treat the condition, I would suggest an in person or virtual consultation to develop a custom and effective treatment plan. It is difficult to precisely define the best option without collecting the same information. I suggest reaching out to an expert for a consultation with surgical and non-surgical methods to get a comprehensive option. Best, Dr. Emer.

Honestly, it is hard to give you a recommendation based on these limited photos and so I would highly recommend an in person consultation with an experienced local aesthetic physician. That being said, hyaluronic acid based fillers like Restylane can help with undereye hollows and volume and Botox or Dysport can help with dynamic lines around the eyes like the crow's feet. It's also important to remember, that some lines are expected under the eye with smiling since the skin needs some give to allow for this movement. 

Hello. Thank you for your question. To get rid of the hollowness under your eye, you will need filler in your tear troughs. You may also need a little Botox to help with the craping. 

Hello there! I would inject directly into that area with a very small amount of neurotoxin (1-2 units per side). This should relax that muscle and decrease the wrinkling you are seeing. I also would recommend treating the laugh lines, since the movement there often contributes to the wrinkling you are seeing. Cheers! Sarah RN BSN 

Hi!
Botulinium toxin (botox) will usually help to attenuate these little lumps under the eyes. If it works, it will need to be repeated on a regular basis. Best regards!