What can be done to reduce bunching of lower lid skin? (Photo)

Only an in person evaluation by an expert eyelids surgeon can determine the best treamtne method for your condition.  From the photos, it appears that you could benefit from a very specific and judicious Botox treatment to orbicularix muscle

Bunching of the skin under the eye, sometimes called the "jelly roll" effect often relates to hypertrophy of the orbicularis oculi muscle of the lower lid. A tiny droplet of Botox (or Dysport or Xeomin) placed into the center of the belly of this muscle frequently softens the hypertrophy and diminishes the bunching effect. As this delicate region is not for inexperienced injectors, you would be wise to seek consultation and treatment by a board certified aesthetic physician with experience and expertise in the more advanced uses of Botox.

I think it was reasonable to try the crows feet first. But since this didn't work, a small amount of Botox or comparable agent in the or ovulated muscle just underneath the lid might help. A more permanent solution is a modified bleph where only a thin rim of muscle is removed, and only minimal skin. Good luck! 

you have what I consider dynamic wrinkles.   Dynamic wrinkles are caused by underlying muscle contraction  and subsequently the skin has no place to go but to wrinkle.  When you are not animating her eyelids are perfect you are not a good candidate for surgery  you should try ever-increasing's small increments of Botox to tone down the muscle activity knowing full well that it'll be improved but never eliminated

Cecilia1109, See another MD and get "Botox" or one of the other agents. Make sure they know what you want treated. this is not an operative problem.

You are young and do not have any excess skin.  When you describe "bunching of the skin" when you smile, you are telling me that it is a thickened muscle that lies directly beneath the eyelashes that is your concern.  This is not a fat bag, which usually is lower on the lower eyelid.You can actually do a little to help yourself by practicing smiling in a mirror.  When you do, try to relax your eyes while allowing the rest of your face to grin as usual.  With a little practice, this can help diminish the roll of muscle.Another alternative is Botox, which actually relaxes muscle.  However, the muscle in question is needed to hold the lower eyelid against the eyeball.  If it were to receive too much Botox (or Dysport), it would temporarily weaken and the eyelid could fall away (temporarily, of course) from the eyeball.A more permanent solution would be a modified lower blepharoplasty in which only a strip of excess muscle is removed. This could "thin" out the muscle while leaving it fully functional to hold the eyelid tight on the eyeball.Would recommend a consultation with a board certified plastic surgeon.Good luck!Elliot W. Jacobs, MD, FACSNew York City