Help me get rid of wrinkling and pooching of lower eyelids please! (Photo)

Hi! I'm in my 30s and am beginning to notice wrinkling around and underneath my eyes when I smile. The lids beneath my eyes also "pooch" up when I smile. When I'm not smiling, I'm very pleased with the appearance of my eyes except for a few fine lines. What are my alternatives? I was thinking botox, but will it look natural? I've also read that people can experience wrinkling like this at any age. Any natural alternatives? I've been using a retinoid and evening cream. Thanks!

Doctor Answers 14

Lower Eyelids and Best Treatment

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These wrinkles under your eyes can be treated with a combination of fillers such as Belotero or Restylane and lasers such as eMatrix.  Botox will not really help for under eye wrinkles, just for Crow's feet around the eyes.  Best, Dr. Green

Lower eyelid wrinkling and muscle protrusion

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I think a good first place to start would be to see a facial plastic surgeon in your area and get their recommendation. Typically, botox or one of the other botox alternatives is an options. Sometimes some fillers can be used as well to plump out fine lines. Alternatively, you might be a candidate for some peels or perhaps laser treatments. Good luck in your area.

Scott Trimas, MD
Jacksonville Facial Plastic Surgeon
5.0 out of 5 stars 20 reviews

Periorbital rejuvenation

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From the photos you have posted, it would appear that you would be best served with a combination of fillers (placed with a mico-cannula) and tightening with a Thermage or a similar radiofrequency device.  Whatever you decide, be sure to see someone with experience in treating this area.

Best regards, -Amar Singh

Amarpreet Singh, MD
Westchester Oculoplastic Surgeon

Dark Circles, Eyelid Wrinkles/Bags Treatment -- Restylane or Belotero with Cannulas, Clear+Brilliant, Eclipse Micropen, Viva

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I suggest a combination of lasers, fillers, needling to improve this area. Thermage/radiofrequncy can also help.  Please see an expert.  Best, Dr. Emer.

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.8 out of 5 stars 207 reviews

Crinkling under the eye when i smile

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This is a common complaint and not always easy to correct in younger persons. Toxins, such as Botox or Dysport, can be tried and will often help, but may not completely resolve the problem. Micro-injections of Restylane or, more recently, Restylane Silk, may be used, but works best for lines that are present at rest.

Whatever you do, go to someone who is very experienced and devotes a significant amount of his/her practice to toxin treatments.

Robert S. Bader, MD, FAAD
Boca Raton Dermatologic Surgeon
5.0 out of 5 stars 3 reviews

Wrinkles and Pooching of Lower Eyelids

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Thank you for posting your photos with your question. Micro injections of BOTOX or Dysport will reduce the lower eyelid muscles from "pooching" up or contracting when you smile. Also, Restylane injections can improve your lower eyelids too. Please consult with a Board Certified Plastic Surgeon who is experienced with these techniques. Best wishes, Dr. Richard Swift

Help me get rid of wrinkling and pooching of lower eyelids please!

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Thank you for your question and photographs.  Your appearance is one of youth and hyper-dynamic eye muscles.  This can be improved with judicious use of Botox to help minimize the contraction of this muscle.  Because this is a more advanced technique, be sure to see an ASPS board certified plastic surgeon in consultation.

Nelson Castillo, MD
Atlanta Plastic Surgeon
5.0 out of 5 stars 80 reviews

Help me get rid of wrinkling and pooching of lower eyelids please!

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The problem that you have in the lower eyelid is what is commonly called "Jolly Rancher". This is a unusually strong lower eyelid muscle (orbicularis) that when contracted creates this massive wall of muscle contraction. This can be diminished by a small amount of Botox in the lower eyelid area.

The other reason of concern in this area that I commonly see if an excess of wrinkles when a patient smile without the thick muscle. This is die to the excess skin only that is brought by the motion of the cheeks higher to the lower lid area. I commonly recommend resurfacing for this problem as it is a skin excess only when the patient smiles rather than an overactive muscle of the lower eyelid.

With the pictures that you provided I think that you have the first problem and not the second one.

Hope this helps,
Dr. Gus Diaz

Gustavo A. Diaz, MD
Charlotte Facial Plastic Surgeon

Botox And Fillers Can Help

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For early aging, small amounts of Botox can help with the lower lid fine wrinkling.
Juvederm or Restylane can be placed deep to help with the lower eyelid groove or tear trough.
Some microjuvederm can even be placed superficially to help in some of the fine wrinkles.
There are options to help.
Best wishes from Dr. Denkler


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I do not think botox along your lower lids will help much.  It may weaken the muscle and cause scleral show.  You are seeing the muscle contract as you smile.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.