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

Question

I just turned 36 and I've had this bunch up of skin and wrinkles under my eyes when smiling since I was about 25. I know that botox will help with the crows feet, but what is best for the under eye when its most prominent when smiling (which I do a lot). When relax I have some creases, but not nearly as much as when smiling. I feel like it ages me 20 years! I've been told volume in the cheek or restalyne in tear troughs. Does lasers or micropen work for this either? Help!

Kian Karimi, MD, FACS · Answer

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.

Nelson Lee Novick, MD · Answer

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.

Jason Emer, MD · Answer

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

Bruce E. Katz, MD · Answer

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.

Melvin Elson, MD · Answer

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

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

Answers (7)

Answer: Restylane for Wrinkles Under Eyes

Answer: Restylane for Wrinkles Under Eyes

Answer: Btox under eyes

Answer: Btox under eyes

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Everything you need to know about Restylane

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

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

Answers (7)

Answer: Restylane for Wrinkles Under Eyes

Answer: Restylane for Wrinkles Under Eyes

Answer: Btox under eyes

Answer: Btox under eyes

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Recommended reading

Everything you need to know about Restylane

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