Q: Dr. Eppley, I would like to schedule an appointment to have something done to my undereye wrinkles. I have attached pictures of me smiling and not smiling and you can see the big difference as to how many undereye wrinkles occur when I am smiling.
A:Thank you for sending your pictures. Under eye wrinkles either are only present when one smiles or becomes much worse when one does smile. (have them at rest) Lower eyelid surgery really treats excess skin and wrinkles when one is not smiling. It is really an operation that treats a static problem since that is how the surgery is done. (patient not moving/smiling) More dynamic undereye wrinkles are treated by Botox injections as this injected agent treats a dynamic problem through muscle weakening. In other words, if your undereye wrinkles are mainly present when you are smiling that is a non-surgical Botox injection treatment issue. However, if a lot of undereye wrinkles are present when one is not smiling, and gets much worse when one does smile, then lower blepharoplasty surgery would be the most effective treatment. It is also important to point out that no treatment will completely get rid of undereye wrinkles, they can only reduce the number seen.
Dr. Barry Eppley