My eyes get really puffy and wrinkled when I smile. How can I lessen this?

Question

I know some wrinkling and closing is normal when you smile, but mine feels disproportionately bad. Would upper and lower bleph be the way to go? I don't really want to change my eye shape.

C. Blake Perry, MD · Answer

Neurotoxin is the best place to start for wrinkle reduction in younger people. This has to be done in a thoughtful manner to avoid changing the shape and function of the lids and cheek. Upper and lower lid surgery do not change dynamic wrinkles. Best to see an eyelid expert.

Kenneth D. Steinsapir, MD · Answer

Those skin crinkles tell others that your smile is genuine. Don't talk yourself into goofy treatments of this because they all have terrible consequences. Botox will slump the lower eyelid. Hyaluronic acid fillers are very fussy. Don't get talked into permanent fillers like grafted fat, Sculptra, or Radiesse. Fat is very hard to control and often goes wrong and the other two can't be reserved if there is a problem. Try a good eye cream.

Mats Hagstrom, MD (license on probation) · Answer

Surgical intervention is indicated when there is a surgical problem that justifies the risk involved with having surgery.
You don’t have the indications or need for blepharoplasty surgery. Botox can help reduce wrinkling in the crows feet area but you’re still contracting skin when you smile.
Instead of calling lines around the eyes crossfeed, we should probably refer to them as smile lines. because they’re associated with happy emotional states they don’t have a negative emotional connotation.
My best recommendation for you is use daily sunscreen, avoid excessive sun exposure, avoid getting overweight and avoid surgery until you need it.
Best,
Mats Hagstrom, MD

My eyes get really puffy and wrinkled when I smile. How can I lessen this?

Answers (3)

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My eyes get really puffy and wrinkled when I smile. How can I lessen this?

Answers (3)

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Recommended reading

Everything you need to know about Eyelid Surgery

Our mission is to create a world where every investment in modern beauty is Worth It.