What can I do for dunked eyes/ excess skin? (Photo)

Question

Hello, I have genetically hollow eyes. When I smile it creates excess skin on the sides and bottom. I have naturally high brows and hate the excess skin when I smile, as it makes my eyes look very small. What treatment or surgery can fix this? I am 30.

Nelson Lee Novick, MD · Answer

From the photos provided, there appears to be some degree of volume deficit in the upper cheeks. And since the upper cheeks provide a major support to the under eyes, whenever there is deficit, there is the inevitable consequence of the development of under-eye tear troughs and hollows. The proper injection of a robust HA filler in the upper cheeks can help to smooth the transition between the upper cheeks and lower lids and diminish the hollows and teat troughs. 
As for the "jelly rolls" that appear immediately under the eyes with smiling, a couple of microdroplets of Botox strategically placed along the "belly" of the muscle responsible can take care of these. 
You would be wise to consult with an experienced, board certified cosmetic dermatologist and best of luck.

Mats Hagstrom, MD (license on probation) · Answer

Smiling typically involves contraction of the zygomaticus muscles and slight contraction of the orbicularis muscle.
Both of these will some redundancy around the eyes.
From your pictures, you don’t have significant hooding of your upper eyelids and I don’t see any skin redundancy.
Botox can help minimize contraction of the ocularis muscle, but will not Have an impact on the dynamic changes from contraction of the zygomaticus muscle.
I don’t think surgical indication is indicated for your concern.
Botox will have a slight impact, but if your concern is the dynamic effect during smiling, then there is no good treatment.
Best,
Mats Hagstrom MD

What can I do for dunked eyes/ excess skin? (Photo)

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