Have weird indents under eye when smiling. Any suggestions? (photos)

Question

Hello, I am a 27 yrs old and I have this weird indent on one of my eyes when smiling. I had botox done before and did not like the outcome. My right eye is the one with the "double" indent while my left doesn't have it. Any advice on how to get rid of it or smoothen it out? It really is bugging me and makes me feel old! Thank you.

Kenneth D. Steinsapir, MD · Answer

Botox in the under eye area is fussy.  Too much treatment will weaken the function of the orbicularis oculi muscle in the lower eyelid.  It is possible to place hyaluronic acid filler in the crease to soften this.  This also requires care.  It is important to balance the inequities here.  Unwanted muscle weakening or over filling of the area will cause an unnatural appearance.  You need to remember that smile lines are dynamic.  You see them in photographs and when you lock the bathroom door and smile into the mirror and tell yourself that you hate the line.  However, if these lines are not there when you face is a rest, you should keep them in perspective.  Smile lines tell people that you mean your smile.  Remember, less is more.

Haena Kim MD, FACS · Answer

I would not recommend botox to correct this problem for you, as all botox will do will relax the crow's feet area at the outer corners of your eyes. From your picture you seem to be quite fair. Individuals with lighter skin tones (and I think I see freckles) unfortunately have thinner skin for the most part. This can lead to earlier onset of fine lines and wrinkles where the skin is thinner on the face (i.e. upper and lower eyelids). What I would recommend first is a good undereye cream. The skin around the eyes is different from the rest of the face and requires a dedicated moisturizer. Next you can try peels to help tighten the skin to remove the etched in lines or under eye filler to help even out the contour of that area. There is no right or wrong way to start, although the result with peels will be slower.

Frederic H. Corbin, MD (license restricted) · Answer

Thank you for the photo and question but an examination is really needed to see what is going on.  So see some experts in your areaDr Corbin

Richard P. Rand, MD, FACS (retired) · Answer

All I see is the edge of the muscle that encircles the eye and closes the lids. When you smile, the muscle contracts and it bunches up in the lower lid and this can cause an edge along the lower border of the muscle. Because it happens when smiling at someone, they certainly don't see it as something negative. You really can't block this effect with Botox because you need that part of the muscle to work for proper eyelid function.

Have weird indents under eye when smiling. Any suggestions? (photos)

Answers (4)

Answer: Muscle edge when smiling

Answer: Muscle edge when smiling

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Have weird indents under eye when smiling. Any suggestions? (photos)

Answers (4)

Answer: Muscle edge when smiling

Answer: Muscle edge when smiling

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Recommended reading

Everything you need to know about Eyelid Surgery

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