What is the best treatment for under eye wrinkles that are particularly visible when smiling? (Photo)

I am 28 but have undereye wrinkles particularly when I smile. I had Botox to try to fix it a year ago but it didn't make any difference and I got a burst capillary or similar which caused a purple spot that didn't go away for a few weeks. Was this because it wasn't performed correctly and should I try again? Would filler or laser treatment be better?

Doctor Answers 4

Undereye wrinkles

The undereye wrinkles you show in your photo cannot be addressed with a neurotoxin such as Xeomin, Botox or Dysport as this will result in an unnatural smile.

While a definitive answer must await an in-person consultation, I have had success using a filler such as Radiesse or Restylane.

I am of the opinion that those wrinkles are the result of a wonderful smile and indicative of a friendly and warm personality.  As such, they should be welcomed rather than erased.


Poway Physician

Under Eye Rejuvenation with fillers, lasers, microneedling/prp, Botox

A combination approach would be best. Botox, fillers, lasers, and microneedling/PRP can improve under eye wrinkles. I suggest consulting with an expert to develop a treatment plan best suited for your short and long term goals. Best, Dr. Emer.

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.9 out of 5 stars 165 reviews

Under eye wrinkles would benefit from Botox and Fillers

I would consider the combination of fillers and Botox to the area. I always use Restylane with a cannula for this. Botox shouldn't cause bruising in most cases. The cannulas help decrease the bruising and improve the safety of injection with fillers. If still not to your satisfaction, treatment with RF such as Infini or laser resurfacing will be of additional benefit.

Steven F. Weiner, MD
Panama City Facial Plastic Surgeon
4.6 out of 5 stars 26 reviews

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Under the eye wrinkles

This is a difficult area to treat and conventional approaches with Botox and fillers do not work well.   It is also a highly vascular area that bleeds easily.  Fillers are generally injected deep on the bone and may not help with superficial wrinkles.  Infini microneedling with radiofrequency is a possible option to consider as it produces collagen in the dermis and may alleviate the wrinkles and crepey skin.  A good skin regimen under professional guidance should help as well.  Best of luck.

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.