What is best for the wrinkles under my eyes when smiling? (photos)

Thank you for sharing your question. Based on your photos, you are an excellent candidate for injections with a neuromodulator such as Botox, Dysoprt, or Xeomin. In particular, a small amount of Botox to the lines under the eyes will soften the appearance of the wrinkles you are noticing. I also recommend a small amount of tear trough filler with a hyaluronic acid filler such as Restylane. This will restore lost volume in the area, which will make you appear less tired. I prefer to inject filler into this area using the microcannula technique, which is essentially bruise-less and minimizes the risk of swelling in the area. I recommend scheduling a consultation with a board-certified specialist who is experienced using the microcannula technique for injecting fillers. 

I have been using Botox for well over twenty-five years and for under the eye crinkles, wrinkles and so-called "jelly rolls" for almost as long. A tiny microdroplet of Botox injected directly into the body of the area in the mid-pupillary line is quick, almost painless, not expensive and may prove quite helpful and certainly worth a try, in my estimation. Although the photos are not ideal, there is a strong suggestion of volume loss in both the cheekbone region and in the cheek region immediately below the eyes. I believe that appropriate use of a volumzing filler to the cheeks, followed by the use a filler for the immediate infraorbital area will go a long way to providing overall facial and under eye improvement, particularly if coupled with the Botox. The under eye region should not be left to novice injectors accustomed to injecting only Botox in eleven lines and simple fillers like plain Juvederm or Restylane into smile lines. You would do well to consult with a board certified aesthetic physician with experience and expertise in the nonsurgical treatment of under eye problems and make sure to ask to see his/her before and after photos before agreeing to proceed. Good luck to you.  

A combination approach would give the most improvement. I recommend lasers, microneedling/prp and fillers. See a cosmetic dermatologist for a formal evaluation. Best, Dr. Emer

Thank you for your photos. Based on your photos you might be a good candidate for Restylane. It is a very flexible injectable filler and is great for tear troughs. It will give additional volume around the hollows of the eye. It’s hard to determine without a in person consultation.  I recommend get a consultation from a board-certified dermatologist. 

Botox will help the appearance of the dynamic lines under the eyes, but the injections require quite a bit of skill so be sure you see a board certified dermatologist or plastic surgeon and has experience in treating this area

Adding restyle in the tear trough will help with the appearance.  The Botox will help relax the muscle to diminish the lines.  At that point you will need to evaluate if that is the result that makes you comfortable.

these wrinkles are from the cheek elevating when you smile.  The are not fixed by botox which gets the eye squint muscles, not the cheek.  You can throw money at this which will help in the short term, while the lids are swollen, but not in the long term.  I don't think fillers will help with your configuration of skin. At some point removing a little lid skin will help but not be perfect. There are silicone based lid treatments which are great for a day, but need to be removed at night.