Skin fold/texture under eye (2 of them) - how can I fix this? (Photos)

Question

Have had filler under under eye and in cheeks but had it dissolved, also had botox around eyes and jaw. Prior to all these treatments the folds were not there. Also find it hard to smile fully doesn't show in eyes and smile is stiff...

Anna Chacon, MD, FAAD · Answer

Thank you for sharing your experience so openly—what you’re describing is frustrating, especially when the changes appeared after treatments that were meant to enhance your appearance. You’re not alone in this, and there are understandable reasons why this can happen.

From your history, a few things are likely contributing:

1. Changes After Filler (and Dissolving It)
The under-eye area is very delicate. When filler is placed and later dissolved, it can sometimes leave behind:

Mild skin laxity or looseness
Subtle textural irregularities
A slightly “creased” or folded appearance when you smile

This doesn’t mean anything was done “wrong”—it’s more about how thin under-eye skin responds to volume changes over time.

2. Botox and a “Stiff” Smile
Your comment about your smile not reaching your eyes is very important. Botox around the eyes can sometimes:

Reduce natural muscle movement
Limit how much the cheeks lift when you smile
Make the under-eye area appear more folded because the skin isn’t being supported dynamically

This can create that “stiff” or less expressive look you’re noticing.

3. Skin Quality and Support
Once volume is removed and muscle movement is altered, the skin may show:

Fine folds (especially with smiling)
Crepey or textured appearance
Loss of smooth transition between cheek and lower eyelid

How to Improve This

The good news is that this is often treatable, and improvement is very possible with the right approach:

• Let Botox Fully Wear Off (if recent):
If your smile feels restricted, allowing movement to return can naturally improve how the under-eye area looks when you smile.

• Skin-Strengthening Treatments:
Focus on improving the quality of the skin rather than immediately replacing volume:

Microneedling (with or without PRP)
Laser resurfacing (gentle, under-eye safe options)
Radiofrequency tightening

These help rebuild collagen and improve that crepey texture.

• Careful, Conservative Re-Volumization (if needed):
In some cases, a very small amount of carefully placed filler in the upper cheek (not directly under the eye) can restore support and smooth the fold indirectly—without recreating the issues you experienced before.

• Topical Support:

Peptides and growth factor-based creams
Gentle retinol (used cautiously and not too close to the lash line)
Consistent hydration and barrier repair

A Reassuring Perspective
What you’re seeing is not permanent damage—it’s more of a temporary imbalance between skin, volume, and muscle movement. Once these are addressed thoughtfully (and often gradually), the area can look much softer and more natural again.

Skin fold/texture under eye (2 of them) - how can I fix this? (Photos)

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