Can Botox or laser help tighten the skin underneath the eye area? Extra under eye fold more prominent when smiling. (photos)

At home peels like cosmelan, enlighten and aerify along with dermarolling (MTS roller with anteage MD ampules) should be started now. There are many things you can do to treat under eye hollows and dark circles. A surgical option to remove skin and/or fat will such as lower eyelid blepharoplasty with or without fat pad repositioning will be the best long term. There are many things you can do to treat under eye hollows and dark circles without surgery. Non invasive less downtime options such as fillers (Belotero, Juvederm Volbella​), lasers (Moxi/Halo/Fraxel/CO2​), Renuvion (J-Plasma), microneedling/PRP, stem cells and microneedling RF like Fractora PiXel8 or Morpheus can all help give some improvement. Accutite can often be used or stronger lasers like erbium or co2 spot treatment can tighten the skin and give very quick improvement in wrinkles and texture. A surgical option to remove skin and/or fat might be the best solution long-term. I suggest you get a formal consultation to see what is best for you and your goals. Best, Dr. Emer.

It's not a 'jelly roll" - It's your orbicularis roll! I wish there were a suitable treatment for under eye crepe skin and heaped up lower lid muscle. Botox may NOT be helpful for this, and laser treatments may not help either. Fillers may be considered, depending on your examination. Thank you. Dr Joseph

It would be helpful to see more of the area and photos of you not smiling as well. Fillers may be an option to help smooth the contours. See an expert injector for an evaluation to learn more.