How to improve the look of my jelly roll and under eye hollowness? (Photos)

Question

Hello! Im 26 F and have noticed my under eye hollows are on my face permanently, not just when im tired. What makes the worse, i have big jelly rolls that have grown in size and have a lot of baggy skin when I smile. I have heard about jelly rolls Botox as and option - is this safe? Also will filler look good in the tear trough area or will it look puffy and lumpy? Thanks!

Raffy Karamanoukian, MD, FACS · Answer

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Best,
Dr. Karamanoukian
Realself100 Surgeon

Best,
Dr. Karamanoukian 
Realself100 Surgeon

Nelson Lee Novick, MD · Answer

Jelly Roll-like bunching under the eyes with smiling is the result of overactivity of the frankfurter-shaped muscles lies directly beneath lashes of the lower lid. For many years now, microdroplets of Botox injected at a few points along this muscle, has proven to be both safe and effective for quieting this overactivity and diminishing the jelly roll appearance. Treatment takes only a couple of minutes to perform and the results are typically seen in one to seven days following treatment. 
As to the under-eye hollows, full face photos with the face at rest would be helpful for determining whehter the use of a robust HA volumizing filler for cheek augmentation would be helpful for addressing this problem (since the upper cheeks are a major support for the under-eyes). You would be wise to consult with an experienced, board certified cosmetic dermatologist injection expert and best of luck.

Anna Chacon, MD, FAAD · Answer

I see this combination a lot in patients your age, and I get why it’s frustrating—it’s not just one issue, it’s how the area behaves when you smile and how it looks at rest.

Let me break it down the way I would if you were sitting in front of me.

About the “jelly rolls”

What you’re calling jelly rolls is just the orbicularis oculi muscle bunching up when you smile. Some people naturally have a stronger muscle there, so it creates that puffy, roll-like look.

Botox can help—but this is one of those areas where technique matters a lot.

If done very lightly and precisely:

It can soften that bunching when you smile
Make the under-eye area look smoother

But if too much is used:

You can end up with a weird, flat smile
Or even slight lower lid weakness (which we want to avoid)

So yes, it’s safe—but only when it’s very conservative. This is not an area to be aggressive.

About your under-eye hollowness

At 26, this is usually not “aging”—it’s more:

Natural anatomy
A little volume deficiency
Light/shadow playing tricks under the eye

Filler can help here, but your concern is valid. This is one of the easiest places to get a result that looks:

Puffy
Lumpy
Or slightly bluish

And that usually happens when:

Too much is placed
It’s placed too superficially
Or it’s put directly into the hollow without supporting the cheek
How I actually approach this

I almost never jump straight into the tear trough.

Instead, I usually:

Start by supporting the upper cheek (midface)
Then decide if a tiny amount under the eye is even needed

A lot of times, just that cheek support alone already softens the hollow more than people expect.

For the jelly roll:

If it’s really bothering you, a very small amount of Botox can help—but I keep it subtle so your smile still looks like you
My honest take

You don’t need a heavy-handed approach. The biggest mistake I see is trying to “fix everything directly” in the under-eye.

The best results come from:

Small, strategic changes
Keeping everything natural
And not overfilling that delicate area

If done right, people won’t think “she had something done”—they’ll just think you look more rested.

That’s always the goal.

Tania Hassanzadeh, MD · Answer

Thanks for your question! My patients love "jelly roll" Botox, and it is safe in the right patient. Candidate selection is crucial to make sure it doesn't cause rounding or sagging of your eyelid, which in a patient as young as you, would be very unlikely. It is only 1-2 units of toxin to the muscle just under your skin on each side.
I can only see your lower eyelid in the first picture you provided. I would suggest starting with the toxin and going from there. Sometimes I recommend combining toxin with laser resurfacing if there is concern for mild excess skin. It's difficult for me to judge if you're a good candidate for filler. The best thing to do is to ask your provider for a personalized treatment plan that they feel confident will achieve your goals. I hope this helps!

Camille Cash, MD · Answer

A small amount of Botox can be used to soften the appearance of jelly rolls under the eyes.  For hollowness HA fillers are commonly used to soften contours.  I encourage you to begin by visiting with an experienced injector to discuss your concerns and learn more about your options.

How to improve the look of my jelly roll and under eye hollowness? (Photos)

Answers (5)

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