Strange triangle shape - What is going on with my under eyes? (Photos)

Question

33 F, 132 lbs and 5’6. I have started to notice that over the past few years I’ve developed these strange triangle structures under my eyes. They have been occurring without having had any work done, however I have gotten crows feet Botox and under eye filler recently, and they seem to have gotten worse. They are only visible when I smile. I have high cheekbones, and I feel like my eyes are deep set, with loss of volume over the years. I have been pregnant twice but otherwise have no history of major weight gain/loss. What could this be? It’s definitely messing with my confidence in my smile.

Nelson Lee Novick, MD · Answer

At least from the photos, there appears to be some upper outer cheek volume deficit. Since the upper cheeks are a major support for the under-eye regions, when there is volume deficit in this region, the under-eye areas may manifest hollowness, wrinkles or, as in this case,  accentuation of a natural contour irregularity. The use of a robust HA volumizing filler to the upper outer cheek regions can not only create a more ideal Ogee Curve and heart-shaped face and establish a smoother lid-cheek transition. 
You would be wise to consult with an experienced, board certified cosmetic dermatologist filler injection expert and best of luck.

Anna Chacon, MD, FAAD · Answer

What you’re describing is actually very common, especially in people with high cheekbones and deeper-set eyes.

Because it only shows when you smile, this is less about a “new defect” and more about how your face is moving and how light is hitting the area. When you smile, the cheek lifts and the under-eye skin stretches—this can create a triangle-shaped shadow or highlight change between the lower lid and upper cheek.

Botox around crow’s feet and under-eye filler can sometimes make this more noticeable, not because anything is wrong, but because small changes in balance affect how light reflects and how the midface supports movement.

In most cases, this is best approached conservatively, often improving midface support rather than trying to directly “fill” the under-eye more.

Strange triangle shape - What is going on with my under eyes? (Photos)

Answers (2)

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