Is lower eyelid surgery the best option to address wrinkles when smiling? (photo)

Question

I’m 36 years old and my lower lids/upper cheeks wrinkle a ton when I smile. Botox in the crows feet area isn’t addressing it. Do I need a lower bleph even though it’s not bulgy?

Anil R. Shah, MD · Answer

Hope this finds you well. Many patients experience this over time. Based on the photo provided a lower lid blepharoplasty using the skin pinch technique would work well for you. With a small incision just under the lash line we are able to eliminate all the extra skin. Best of luck.

Kenneth D. Steinsapir, MD · Answer

What I might actually recommend for you very much depends on an actual in person consultation. There is simply no substitute for a detailed in person assessment. Don't let anyone schedule service based on a "zoom consultation." The lower eyelid and cheek is a complex system of glide planes. You may not like your wrinkles but some of these potential treatments can cause the tissue to heap in unexpected ways without the ability to repair the issue. So-called skin pinch lower blepharoplasty can cause surprising changes in the lower eyelid so they are not a benign as you might have been lead to believe. Chemical peels and laser resurfacing are also effective at soaking up the excess skin but can also lead to issues with how these line form when you simile. Botox treatment of the orbicularis oculi muscle in the lower eyelid is unsatisfactory because this muscle helps support the eyelid against the eye surface. Your best option may be a thoughtful infracillary skin only lower blepharoplasty with strengthening of the lateral canthal angle or you might do extremely well in a hyaluronic acid filler treatment usually with Restylane. An in person physical examination is needed to determine what is right for you.

Mats Hagstrom, MD (license on probation) · Answer

Botox in the crossfeed has little impact on the dynamics of your cheek, moving up when you smile, guy
The Botox in the Orbicularis muscle helps minimize wrinkles when you contract the orbicularis muscle only. It reduces wrinkles when you squint, but not when you smile. Lower eyelid, blepharoplasty is a contouring procedure and will not address the wrinkles in your lower eyelids when you smile.
I suggest you simply accept that this is a normal physiological impact of contracting your zygomaticus muscle.
Smile lines are associated with positive emotional expression.
There is no good treatment for this.
Best,
Mats Hagstrom MD

Is lower eyelid surgery the best option to address wrinkles when smiling? (photo)

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Is lower eyelid surgery the best option to address wrinkles when smiling? (photo)

Answers (3)

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Everything you need to know about Eyelid Surgery

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