Which procedures will help with under eye skin bunching up when I smile? (Photo)

Platelet Rich Plasma and a small amount of Botox are great ways to shape the fragile under eye skin, reduce muscle animation, thicken the skin, add moisture to the skin and fill in some of hollowing that you display in your pictures.  The PRP can be directly injected into the area and be very effective!Good luck!In good health,Ellen Mahony, MD

There are several treatments available to restore the youthful look under your eyes including dermal fillers, Botox, microneedling with PRFM, or laser treatments. A consultation will help identify the best option to restore volume to the eye area and promote collagen growth, reducing fine lines, wrinkles and dark circles. Along with your treatment, discuss with your provider a good skin care regime for the future. 

Usually, 27 year old is too young to have skin removed from under eyes (but fat bags okay). Not sure if you would benefit from skin removal. You may benefit nonsurgical options such as laser and filler. Personal consultation is needed. Skype consultation available.

Thank you for your question. I find that the under eye area responds very well to a multifaceted approach. PRP may be beneficial to increase collagen and elastin in more crepey skin, while Botox can help relax the more dynamic lines and wrinkles. Seeing a qualified physician in your area is always a good start. 

An excellent treatment is Botox placed gently under the eye to help soften the "skin-bunching" muscles.
Patients need to be checked and have an good SNAP TEST under the eyes prior to treatment with Botox.

I'm sorry to hear about your allergies. Have you seen a specialist to help your symptoms? The itching and tearing and swelling caused by irritants should be treated and addressed first since that is the underlying issue! I'm sure it's not helping with the rest of your skin either!
As for treating the lower lids and tear trough, I agree with my colleauges that a combination of Botox to relax the sphincter like orbicularis muscle, filler to smooth the contour of the tear troughs and make you look less tired, and microneedling with PRP to boost collagen and improve skin quality - less crepey will give you a very nice result.
Make sure you find an experienced injector and get those allergies under control! I hope this helps. -Dr. Leong

Filler may be of some benefit.  Occassionally a laser treatment can help as well.  It may be a little soon to consider surgery.

Thank you for your question and picture. Under eye wrinkles and volume loss will respond well to dermal fillers, Botox and micro-needling with PRP. A combination of these treatments will give you the best results. I hope this help. All the best, Dr. Michon

A combination of botox and filler can definitely improve this area. Remember that for the treatment you should always be offered FDA-approved options by a physician that can best recommend the treatment according to your specific concerns. Make sure to discuss a good skin care regimen as well for protection and prevention of facial fine lines. Best,