I am 26 yrs old and have bunching of skin when smiling. Seems to be getting worse over the years. The 1st picture at rest, I do have concealer on, but I only have deep tear troughs and dark circles. The 2nd picture I am smiling, but trying very hard to not activate the muscles that push my cheek bones/skin up. Bunching of skin is less pronounced. The 3rd picture, bunching of skin happens when I smile naturally. Very self conscious of this. Would Botox, filler or a combination help this?
October 24, 2018
Answer: Bunching under eyes when smiling Based on the photos you shared, your cheeks are elevating when you smile (this is normal) and with your anatomy, as the cheek mound moves upward it is accentuating the under-eye hollows. Dysport or Botox would reduce the "crow's feet" at the outer corners of the eyelids and could reduce the roll just under the eyelashes when you smile but it wouldn't affect the "cheek shelf". Some under-eye filler can blend the lower lid hollows to the cheek area to a degree but not completely. Surgically, the lower eyelid fat pads could be repositioned into the hollow area to blend it even more effectively but again, the cheek shelf won't entirely disappear nor should you want it to as you don't want to lose your natural-looking expression.
Helpful
October 24, 2018
Answer: Bunching under eyes when smiling Based on the photos you shared, your cheeks are elevating when you smile (this is normal) and with your anatomy, as the cheek mound moves upward it is accentuating the under-eye hollows. Dysport or Botox would reduce the "crow's feet" at the outer corners of the eyelids and could reduce the roll just under the eyelashes when you smile but it wouldn't affect the "cheek shelf". Some under-eye filler can blend the lower lid hollows to the cheek area to a degree but not completely. Surgically, the lower eyelid fat pads could be repositioned into the hollow area to blend it even more effectively but again, the cheek shelf won't entirely disappear nor should you want it to as you don't want to lose your natural-looking expression.
Helpful
October 24, 2018
Answer: What should be done for the bunching of skin when I smile? When One smiles, a lot of facial muscles get activated. The first group is located deep in the cheek. The most important are levator labi superioris and the zygomatic major muscles. These muscle should not be treated with Botox at all, because one will not be able to smite or the smile will be uneven. These muscles push the cheeks up and may cause some bunching under the eyes and the lower part of the crows feet. When one smiles harder the orbicularis muscles start contracting and cause bunching in the crows feet area and some times on the lower eyelids. These muscles can be treated with Botox and this will improve the bunching of the skin. The tear throughs can be improved by injection of gentle fillers like Restylane deep under the muscle, and with a microcannula instead of a sharp needle. This would lessen the chances of an intravascular injection that could be very dangerous in that area. All facial injections should only be done by experts with a detailed practical knowledge of the anatomy. An in person evaluation would be necessary to confirm these suggestions.
Helpful
October 24, 2018
Answer: What should be done for the bunching of skin when I smile? When One smiles, a lot of facial muscles get activated. The first group is located deep in the cheek. The most important are levator labi superioris and the zygomatic major muscles. These muscle should not be treated with Botox at all, because one will not be able to smite or the smile will be uneven. These muscles push the cheeks up and may cause some bunching under the eyes and the lower part of the crows feet. When one smiles harder the orbicularis muscles start contracting and cause bunching in the crows feet area and some times on the lower eyelids. These muscles can be treated with Botox and this will improve the bunching of the skin. The tear throughs can be improved by injection of gentle fillers like Restylane deep under the muscle, and with a microcannula instead of a sharp needle. This would lessen the chances of an intravascular injection that could be very dangerous in that area. All facial injections should only be done by experts with a detailed practical knowledge of the anatomy. An in person evaluation would be necessary to confirm these suggestions.
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