Deep crease under eyes when smiling. Would lower blepharoplasty help? (Photo)

Question

Ive had botox and filler to try and fix this but nothing is helping. They arent there when resting but I hate smiling because of it. It makes me feel old and I'm 28. Any recommendations? Would lower blephorplasty help?

Carlos Mata, MD, MBA, FACS · Answer

Hi Kaseyr,Thanks for your question and your photos. I agree with the majority that botox would help soften the lines but not make them completely go away. Surgery at your age would be too agree and could lead to an outcome that may not improve but worsen your smile. A strip of muscle would need to be cut but that could lead to ectropion which is the white of eyes showing after the operation. Be patient and continue to smile.Botox could improve your outcome. Seek someone with experience in botox for the eyes. good Luck.All the best,Carlos Mata MD, MBA, FACS

Sheila S. Nazarian, MD · Answer

No, a lower blepharoplasty is not what you need. Personally, I think your eyes look great when you are smiling. They're expressive. For now, I would advise you to leave things alone. My best,
Dr. Sheila Nazarian
@drsheilanazarian on Instagram

P. Daniel Ward, MD · Answer

Hi Kaseyr,Thanks for your question. I think you are much too young to consider a blepharoplasty. I would start with a little low dose Botox under the eyes. If properly performed, this is safe and can be quite effective. It is also a much cheaper option than surgery!Please let us know if you have any other questions or concerns!Good luck!

William Portuese, MD · Answer

Botox placement in the lower eyelid muscle will help with the contraction process of the muscle which should help with the  decrease when smiling.  Lower Eyelid surgery will not help this. Keep smiling.

Jeffrey M. Joseph, MD · Answer

These creases are caused by bunching of your lower eyelid muscle called the orbicular coulee muscle. Relaxing this muscle with a low dose treatment of botox can be very helpful in softening the lines. Make sure you find someone experienced in using botox this close to the eye.

Michael Elam, MD (retired) · Answer

Dear kaseyr, I would not suggest having any lower lid blepharoplasty procedure as this will not address the concerns you have. This is simply the contraction of the lower eyelid muscle. I personally do not inject botox in this area however it is suggested by other surgeons this could be helpful. You are a lovely young lady so keep smiling and understand no one else notices the creases but you!! Best regards, Michael V. Elam, M.D.

Ronald V. DeMars, MD (Retired) · Answer

The crease is caused by a small muscle flexing in the eyelid as part of your natural smile. Blepharoplasty would be a bit drastic at your age for that problem. Botox, if properly placed and redone every 3-4 months will do the trick. Just make sure the person doing the botox is not only an MD but an MD familiar with eyelid surgery so they understand the delicate anatomy.

Deep crease under eyes when smiling. Would lower blepharoplasty help? (Photo)

Answers (7)

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