What treatment is best for the smile lines around my eyes? (Photos)

Question

When I smile, I get all this skin bunching up under my eyes. Like to minimize this yet not sure what to do. What would you recommend? Age: 57

Lexie Wang, MD · Answer

When you're trying to address dynamic wrinkles/lines, you almost always have to consider: (1) how to reduce the movement that causes the lines -- in this case it would be doing botox -- and (2) how can you build up the strength/resiliency of the skin quality and tone so that it is less likely to wrinkle --> skin treatments like topicals/lasers/microneedling/etc.

Kyle Kimura, MD · Answer

Great question! 
When smiling, your orbicularis muscle contracts and will create creases no matter your age. However, when you have a slight excess of skin, this can cause some bunching which can be bothersome for patients. A couple of options to consider: botox can soften how strongly this muscle contracts and slightly decrease the amount of bunching; laser resurfacing can sometimes tighten the skin a bit and improve the bunching slightly; a lower blepharoplasty with a skin pinch (excision of skin) will also likely help. It is important to note that while these will all likely help to some extent, they are unlikely to completely resolve. 
I hope this helps and best of luck!Kyle Kimura, MD

Zoran Potparic, MD · Answer

Based on these photos a combination of lower and upper blepharoplasty with periodical fat grafting would be my suggestion. In person consultation with a board certified plastic surgeon familiar with these procedures is recommended. Good luck.

Nelson Lee Novick, MD · Answer

Botox has been a gold standard for treating smile related crow's feet  for about thirty-five years. I have personally been using it for nearly that long myself for that purpose with very gratifying results That would be a start. 
If you are still bothered by the undereye area, the use of a robust HA voluminzing filler properly injected can be used to further improve this area. 
You would be wise to consult with a board certified cosmetic dermatologist injection expert and best of luck.

Gary M. Horndeski, MD · Answer

You would benefit from Botox to decrease the wrinkles around the eyes. Another alternative for you to consider would be an extended brow lift. Your forehead is quite high. The incision is placed in front of the hairline to lower the hairline, pull up the eyebrows and extend the incision down in front of the ears to pull the upper and mid face more lateral and up to decrease the wrinkling.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

S. Daniel Huang, MD · Answer

These laugh wrinkles seem like dynamic lines. You may try Botox or other neurotoxins for the areas of interest. You might want to start out with a low dose and increase every 3-4 months to get the desire effect. Overdosing will give an unnatural result, because a full smile requires some laugh lines. Best wishes.

What treatment is best for the smile lines around my eyes? (Photos)

Answers (6)

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