What is best for my under-eye wrinkling when I smile? (photos)

I currently have Botox in my glabella and crows feet area, which helped immensely (especially in the glabell). I've only had the Botox for a little over a week so there is still some residual lining. However, when I smile I have loose skin in the under eye area that bothers me. What is the best solution for this?

Doctor Answers 7

Under eye filler

Dear JackieTeeTee,

A touch of filler in the tear troughs would smooth the area under your eyes. 

I would be happy to help you!


Dr. Y

New York Facial Plastic Surgeon
5.0 out of 5 stars 5 reviews

Lower lid hollowing

You have a hollow lower lid.  At rest this makes your lids look dark.  When you smile you get the wrinkling.  If you put some volume into the lower lid with filler, it should help.  Some laser resurfacing can also help to improve the skin texture.  You will not eliminate all the lines but should improve their appearance. 

John J. Martin, Jr., MD
Coral Gables Oculoplastic Surgeon
5.0 out of 5 stars 27 reviews

Under eye wrinkling

Thank you for your question.  The wrinkling when you smile is normal as the skin comes together with smiling.  Treatment options would include skin treatments in the form of lasers or chemical peels to the area.  Conservative dermal filler injection to the area may also provide some improvement, and possibly in combination with a skin treatment.  Good luck!

Paul Nazemi, MD
Newport Beach Oculoplastic Surgeon
5.0 out of 5 stars 4 reviews

Under Eye Wrinkles - Multiple Options Available

Under eye wrinkles are best treated with fillers like Belotero, lasers, peels, and micro-needling with PRP. Please see an expert to discuss the best treatment options for you. 

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.8 out of 5 stars 191 reviews

Eye rejuvenation

There are a couple options. I will list them in order of effectiveness which also correlates to downtime. This is from redundant skin and orbicularis oculi muscle. When you smile the muscle contracts. They did a nice job with your lateral eye botox FYI.

You can have a few units of botox injected in this area (below the lid) to stop the orbicularis oculi from bunching the skin. This will help but not cure your problem.

Laser or chemic peel for resurfacing causes some tightening and smoothing of this very thin skin. Again will help but likely not cure your issue.

You could have a lower lid blepharoplasty with removal of a small amount of skin. This in conjunction with fat grafting would give you the best result in my hands. 

Hope this helps.

Best of luck,


Benjamin Caughlin, MD
Chicago Facial Plastic Surgeon
5.0 out of 5 stars 10 reviews

Lasers, peels, surgery

Thanks for the great question. Excess lower eye lid skin always becomes more apparent once other wrinkles in the face have been treated. There are only a few ways to deal with excess lower eyelid skin. For mild excess a peel may help tighten the skin up. If there is mild to moderate excess, then lasers typically work very well to deal with the skin. If there is a large amount of skin excess, then the only way to really deal with it is by having it removed with surgery. I would go see a surgeon who is able to offer you all of these modalities so that they are able to examine your skin and give you the best possible treatment plan. Best of luck!

~Dr. Sieber

David A. Sieber, MD
Bay Area General Surgeon
5.0 out of 5 stars 31 reviews

A little bit of Botox

A very small amount of Botox or Dysport can be injected in the lower eyelid to reduce wrinkles when you smile. 

Elba Pacheco, MD
Annapolis Oculoplastic Surgeon
4.2 out of 5 stars 6 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.