Severe Wrinkles and Puffines Under Eyes when Smiling? (photo)

Hi im 24 year old male when i smile my eyes become wrinkled and puffy what would be the best procedure to correct this issue.

Doctor Answers 4

Normal phenomenon

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Wrinkling underneath the eye and at the crows feet is normal when smiling. You could consider subtle botox injections to minimize the wrinkling, but have to be careful not to overdo it as it could cause tearing problems or eyelid malposition.

Seattle Oculoplastic Surgeon
5.0 out of 5 stars 42 reviews

Severe Wrinkles and Puffiness Under Eyes when Smiling?

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      There may be a role for filler to the tear trough or a modified lower eyelid surgery, but this needs to be determined after an exam.  Kenneth Hughes, MD Los Angeles, CA

Lower eyelid wrinkles upon animation

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  The decision to perform lower eyelid pinch technique is performed at rest, not on animation. If there is excess skin on the lower lids upon rest, then consideration can be  given to a pinch technique of excess skin and then closed with Histocryl tissue glue.

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 157 reviews

Lower eyelid wrinkles treatment

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Lower eyelid wrinkling and folding (puffiness) is normal when smiling, even in young people. This is not an aging problem. If the problem only shows up when you smile, theoretically, neurotoxin (Botox, Dysport, Myobloc) injection can reduce the dynamic wrinkling but the resulting paralysis would probably cause significant lid dysfunction(drooping, tearing, dry eye). Filler injections to fill in the depressions between the folds might be helpful if there are depressions when not smiling.

You did not submit any photos with relaxed lids so full evaluation is not possible.This needs to be performed by an experienced eyelid surgeon.

C. Dennis Bucko, MD
San Diego Plastic Surgeon

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.