What can I do to treat deep undereye wrinkle due to smiling? (Photo)

I am 31 years old and have several fine lines and wrinkles under my eyes at rest and even more so when I smile. Would dermapen/laser help with this or do I have to have surgery to fix the problem? I'm so young and I know these will only get worse as I age!

Doctor Answers 8

Softening of Deep Under Eye Wrinkles with Fillers

Dear Slopez311:

Looking at our photos, you would benefit initially from filling of your tear trough area with a filler like Teosyal Redensity II and softening of the fine under eye lines with Botox, lasers, chemical peels and maintenance topical retinols.  All the best.

Kelowna Physician
5.0 out of 5 stars 9 reviews

Eye wrinkles

I would recommend a combination of Botox and Restylane treatments for your under eye wrinkles.  First, Restylane can be injected into the tear trough ( the wrinkle that you see at rest by the nasal portion of your eye).  Then Botox can be injected into the muscle that helps to close your eye to help diminish the appearance of the wrinkles when you smile.  Good luck!

Dark Circles, Eyelid Wrinkles/Bags -- Restylane or Belotero, Laser C02/Erbium Resurfacing, Microneedling, Viva/Intensif, Fraxel

Wrinkles can get improvement with lasers, microneedling/PRP, peels, and skin care.  Botox can sometimes help. Best, Dr. Emer.

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.8 out of 5 stars 196 reviews

Combination treatment with Botox and filler to the undereyes

You have two issues. One is hyperactivity of the orbicularis oculi muscle which is resulting in the undereye lines when you smile. The second is volume loss in the tear trough which is creating a dark shadow under your eyes. A small amount of Botox carefully injected into the orbicularis oculi will help with the dynamic undereye lines while filler such as Restylane injected into the tear troughs will improve the dark shadows. Both injections require an experienced injector so see an expert!

Shaun Patel, MD
Miami Physician
5.0 out of 5 stars 58 reviews

Undereye wrinkles

Good question.  It is difficult to answer because treatment differs for every patient.  This is a common concern for many people. The key goal is to make the area look better without making it look like you did something.  Botox and various fillers are good options and work together to make the area look better.Lasers and peels are good options but have a lesser effect than the above. If you have never had any treatments, I would recommend discussing your concerns with an appropriate physician and come up with a plan.  I would start off slowly and work up to your goal. Everything will require maintenance because we want to slow the changes caused by more and more birthday candles!!!  Blame the candles!!!

George Orloff, MD, FACS
Burbank Plastic Surgeon
4.1 out of 5 stars 11 reviews

Under eye rolls when smiling

This is primarily due to overactive obicularis oculi and would respond to Botox. However, you also have volume loss here and filler in the tear trough and upper cheek would help. I use cannulas for this to minimize bruising and swelling.

Steven F. Weiner, MD
Panama City Facial Plastic Surgeon
4.7 out of 5 stars 41 reviews

Wrinkles under the eyes

This is a very common concern that I see in my practice, and I have had very good results by taking a comprehensive approach to rejuvenating this area. The surface can be improved with good skin care geared toward thickening the collagen and increasing hydration.  Tightening can be created with a mild to moderate chemical peel or laser treatment. The lid to cheek junction can be addressed using injection of filler. Occasionally the muscle activity can also be treated with something like Botox, but I find this is rarely needed under the eye. 

Sean R. Weiss, MD, FACS
New Orleans Facial Plastic Surgeon
5.0 out of 5 stars 14 reviews

What can I do to treat deep undereye wrinkles?

Thank you for sharing your question and photographs.  I see your area of concern and would recommend a multi-modal form of treatment.  Start with a good skin care regimen incorporating the use of a retinol and eye cream.  Then use small amounts of botox to help soften your wrinkles and dermal fillers to help smooth the transition from your eyelid to cheek.  Hope this helps.

Nelson Castillo, MD
Atlanta Plastic Surgeon
4.9 out of 5 stars 68 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.