What is the best treatment for my under eyes? (Photo)

The bulging of the belly of the under-eye muscle with smiling is not that uncommon. The use of a couple microdroplets of Botox to the belly of the muscle (pretty painless and takes literally about two seconds to perform) would be worth discussing with an experienced, board certified cosmetic dermatologist. Hope this helps and best of luck.

The eye area needs significant combinations to get improvement. Lasers like erbium, co2, halo, profractional/contour, or Fraxel can all be used to build collagen long term. Plasma pen is a newer less invasive option but will take many treatments and require proper skincare. Plasma Pen is focused electrical plasma energy to tighten skin, producing small columns of energy just above the skin, allowing the skin to tighten to help improve wrinkles. This area will have 3-5 days of small “dots” that will then scab and peel, then the skin will tighter and brighter after. Numerous treatments are needed over lasers where only one or two give a bigger result, but more downtime. After plasma pen you NEED peels 2 weeks like later Cosmelan, enlighten or aerify, see emeragecosmetics (link). At home derma rolling should be started weekly even after plasma pen or lasers to further increase collagen, see emeragecosmetics AERIFY x anteagemd stem cell ampules. To properly heal you need light Stim red LED, EmerageSkin refit face, refit eye; AnteageMD serum, silagen silicone gel, jan Marini bioshield, EmerageSkin enzymatic polish, and EmerageSkin hyla b and AOX, and Sente dermal repair. Otherwise there is EXTREME risk of pigmentation issues and “dots” in the treatment area. at home peels like cosmelan, enlighten and aerify along with dermarolling (AERIFY emerageskin roller with Anteage MD ampules) should be started now regardless for antiaging, sun damage, and wrinkle prevention. 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 eyelid blepharoplasty with or without fat pad repositioning (if doing lower eyelid surgery) 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, lasers, microneedling/PRP, cosmelan peels, 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. I suggest you get a formal consultation to see what is best for you and your goals. Best, Dr. Emer.

Thank you for your question and photograph.
First I would avoid injectable fillers in the eyelid is #1 they will not improve the concern you have and #2 they can have significant dangerous complications.
From your photographs I see 2 issues. #1 the muscle contractions when you smile cause the wrinkling out at the corner of the eye. Botox in the outside corner of the eyelid can lessen the wrinkling that you see which is often called crows feet.
It also appears that you may have excess intraocular fat causing a bulge in the lower eyelid. In person examination is necessary to document this. However if you do have excess fat causing the puffiness then a procedure called a transconjunctival lower eyelid blepharoplasty with arcus marginalis release and fat grafting can correct the problem.
Seen experienced board-certified plastic surgeon or oculoplastic surgeon with experience in this procedure.