Despite having both Botox and fillers, I still have bad under eye wrinkles when I smile. What else is there? (Photos)

There are many different treatments to address under eye wrinkles. Start with an eye cream, from a medical grade line of skin care, good at- home skin care is very important.  A low dose Neuromodulator, such as Botox just under the eye can also help with these fine lines. There are also multiple treatments that will assist in collagen stimulation to decrease the lines under your eyes, such as Fraxel, Thermismooth, Microneedling, PRP (platelet rich plasma) injections, Miconeedling with radiofrequency (such as Vivace) and Ultherapy, which uses ultrasound to generate heat and tighten skin under the eyes (and the entire face). I hope this helps!

Thank you because yours is a common question.  It looks like there is still a slight volume loss so PRP injected in the tear trough area can add some volume.  In addition consider a few radiofrequency resurfacing procedures to tighten skin laxity  with topical or injected PRP or microneedling and topical or injected PRP.  For injections pretreat with arnica plus vitamin K cream to reduce bruising with your skin type.