Botox did not help. What will help the under eye wrinkles? (Photos)

Those lines under the eyes are usually from very fine, delicate muscles that Botox can’t fully treat—especially if you already had crow’s-feet Botox and still see the bunching. In most people, that creasing is a mix of thin skin, mild laxity, and natural movement.

Options that tend to help more in that area are treatments that improve the skin itself, not freeze the muscle are resurfacing lasers to thicken and smooth the under-eye skin, Microneedling RF for tightening if there’s looseness, or under-eye filler (only if you’re a candidate).

Most people need a skin-quality treatment rather than more Botox. An in-person exam is important so someone can see how your lower lid moves when you smile and decide which option fits your anatomy.

Hello, my name is Ranen and I am an aesthetic nurse here at Aesthetic skin. Looking at your photo, it seems to me that doing laser resurfacing undereyes will dramatically improve the texture and reduce the fine lines and wrinkles. I have seen many patients with similar concerns as you and was able to help with doing a laser resurfacing treatment. You are more than welcome to to call the office to schedule a consultation to get some information regarding this and address other concerns you may have.

It’s quite common to still notice fine lines and bunching under the eyes even after Botox — this area can be particularly challenging because the skin there is delicate, thin, and tends to show movement easily. Botox helps mainly with muscle-related wrinkles, like crow’s feet, but it doesn’t address skin laxity or crepiness under the eyes.

For dynamic under-eye wrinkles (those that appear when you smile), treatments that improve skin texture and firmness often work best alongside Botox. Options that can help include:

Skin boosters or microneedling with PRP to improve collagen and elasticity.

Laser resurfacing or radiofrequency treatments (like Fraxel, CO₂, or RF microneedling) to tighten and smooth the skin.

Under-eye filler in select cases — if there’s volume loss contributing to the bunching effect.

Topical retinol or peptide-based eye creams to strengthen and thicken the skin over time.

Your photos show that the movement is quite natural when smiling — the goal isn’t to eliminate expression but to soften how the skin responds to it. Combining gentle skin-tightening and collagen-boosting treatments with well-placed Botox usually offers the most natural improvement.

There are a few options you can consider to treat the under eye area. Fillers can provide volume to improve the contour. Another option is Morpheus8. This treatment combines RF technology with microneedling to improve overall tone and texture. I've included a video on this treatment that I hope you find helpful. We also recommend using medical grade skin care products like Transform MD and wearing sunscreen every day.

Hello, you have excess skin under your eyes that can be corrected with lower blepharoplasty and, if necessary, lower eyelid lipofilling.