How can I get rid of these terrible wrinkles under my eyes that occur when I smile?

These undereye wrinkles have seemingly worsened in the last few months after losing 50 pounds and I have heard that Botox is the answer. I have had approximately one syringe of Radiesse in each cheek. Will adding more help as some of the dynamic wrinkles extend into my cheeks? Or is it simply the tear troughs needing a filler?

Doctor Answers 11

Treating wrinkles around the eyes with Botox

Congratulations on the desired weight loss! Yes, Botox can help improve wrinkles around the eyes. However, for patients who have facial volume loss, facial fillers (ex. Radiesse, Restylane, etc) can rejuvenate too. Many patients can benefit from combined treatments. Without an office examination, it's difficult to determine appropriate options for you. If you haven't already, then speak with your dermatologist or plastic surgeon.

Dr. Chaboki

Washington DC Facial Plastic Surgeon
4.9 out of 5 stars 85 reviews


The best way to determine what is best for you is to see a physician in person. You should see a board certified plastic surgeon in your area to discuss your options.


Asif Pirani, MD, FRCS(C)
Toronto Plastic Surgeon
5.0 out of 5 stars 35 reviews

Wrinkles Under Eyes

Thank you for your question. Botox will help minimize the lines when you smile. Fillers will help fill in volume loss. I would recommend consulting with a Board Certified Dermatologist for best treatment plan. I hope this helps!

Sonia Badreshia-Bansal, MD
Bay Area Dermatologist
3.9 out of 5 stars 12 reviews

Combination of treatments for wrinkles

Congratulations! After losing a significant amount of weight, just like in other areas of the body, there may be volume changes in the face that you might notice. Volume loss can be corrected with a variety of fillers depending on the location and intended goal, while dynamic wrinkles can respond to Botox injections. Many aesthetic concerns are best served by a combination of the two. Your physician may also want to address the possibility of a surgical correction if redundant eyelid skin is playing a role.

Joshua L. Fox, MD
Long Island Dermatologic Surgeon
4.9 out of 5 stars 19 reviews

Under eye wrinkles

There are several factors that can contribute to undereye wrinkles that you may want to consider.  Simple skin redundancy may appear as fine lines and wrinkles.  This can be addressed with either a good skin care program, chemical peels or laser treatment.  If redundancy is severe enough, surgery may be required.  If volume loss is contributing to the wrinkles then adding volume can be very helpful.  Finally if the wrinkles are formed because of the muscle action around the eye, a neuro toxin like Botox may be the best treatment option.  I have found that quite often a combined approach with 2 or more treatment modalities achieves the best results. 

Sean R. Weiss, MD, FACS
New Orleans Facial Plastic Surgeon
5.0 out of 5 stars 14 reviews

Botox for wrinkles under the eyes

Congratulations on your weight loss. Botox can help modest wrinkles around the eyes.  If some of the wrinkling is due to major volume loss, Botox alone may not be the answer. You may need fillers or even surgery, so consult in person with a board-certified plastic surgeon for best answers. Best wishes. 

Francisco Canales, MD
Santa Rosa Plastic Surgeon
5.0 out of 5 stars 35 reviews

Eye Rejuvenation

Congratulations on losing 50 pounds.  Since you have lost a great deal of weight then there will be a volume that needs to be replaced in the face.  The skin laxity may also need to be addressed as well. If you could post a photo it would be helpful.  The dynamic wrinkles can be helped by Botox.  The areas under the eyes will probably need a filler like Belotero.  Belotero when carefully placed in the tear trough area will look subtle and natural and you should be happy with the results. Please consult a board certified dermatologist with a great deal of experience with Belotero for the delicate tear trough area.

Michele S. Green, MD
New York Dermatologist
5.0 out of 5 stars 76 reviews

Wrinkling of the lower eyelid when smiling

Congratulations on your weight loss!!  If you are looking to improve your appearance and how you feel nothing is more beneficial than weight loss.  I am asked weekly the same question you have posed.  Wrinkling of the lower eyelids when smiling is the result of several different issues.  Muscle around your eye does contract when you smile and a small amount of Botox or other neuromodulator into the lower eyelid muscle will help decrease the contraction of the muscle and decrease wrinkling. The other issue has to do with the tone and elasticity of your eyelid skin.  As we age and are exposed to elements such as sun, wind, smoke, etc. our skin loses a great deal of what we call elasticity.  In young healthy skin the skin will contract and not bunch because of good elasticity.  In skin that is not as healthy, the skin will contract but tends to bunch.  It occurs around the eyes, crows feet, and in the lower eyelids.  I would suggest some Botox for this issue for immediate improvement, but you should also consider discussing the condition of your skin with a knowledgeable specialist.

Philip S. Schoenfeld, MD, FACS
Chevy Chase Facial Plastic Surgeon
4.7 out of 5 stars 30 reviews

Botox for wrinkles around eyes

Botox is great for dynamic wrinkles around the eyes such as Crow's feet, and even in small doses carefully applied right under the eyes too. Not everyone benefits, and sometimes tear trough filler is also required. Best to speak with your dermatologist about the best treatment options for you.

Benjamin Barankin, MD, FRCPC
Toronto Dermatologic Surgeon
4.9 out of 5 stars 49 reviews

Wrinkle fillers and botox

Botox is great for the wrinkles on the sides of the eyes, your crows feet. But if you have excessive skin after loosing weight, then I think fillers (like juvederm, restylane) or a blepharoplasty with skin removal is the appropriate intervention. See someone in the office so they can see if it's just a loss of volume or if it's excrssive skin. Hope that helps! 

Samir Undavia, MD
Princeton Facial Plastic Surgeon
5.0 out of 5 stars 38 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.