Restylane, Botox, or Laser Treatment for Under Eye Wrinkles?

You have three options in my hands. 1. Superficial peel or micro laser to tighten the skin. This could also include thermismooth or some other radiofrequency options 2. Filler or botox to fill the wrinkles or manipulate the way the muscles contract or 3. (probably the best and most effective option) a small skin pinch with muscle suspension. If you have time flip through my photos. There is a very young and pretty girl about your age who I did just that on. She is very happy and it was a relatively straight forward procedure.  There is no problem with starting slow with the more simple options. Everyone is different. Some people want a big change and treatment others are willing to be patient with slower approaches. Find a surgeon you trust and be clear with your goals.Hope this helps,Best of luck,DrC

Botox or Dysport can be effective in softening  lines around the eys "crows feet",  the area directly under the eye may be treated with microbotox, a more dilute concentration that targets the muscle in the skin rather than functional muscle .A skilled injector may be able to provide more information on this treatment.BestDr. P

Hello GoGoEyes! You must be 48 now; I wonder what success you've found for your under-eye wrinkles? Yours remains a great question, so I'd still like to address it.
Best results will come from all of the above treatments paired with a comprehensive skin care program. All skin experts will agree that healthy skin will allow us to provide best results. Protect your skin from the Texas sunshine by applying and reapplying sunscreen every day.  Skin care, diet, hydration, exercise, and lifestyle factors will greatly affect the quality of your skin and ultimately your smile lines. 
CO2 laser is my top recommended approach for you; you'll get maximum benefit if we improve the quality of your skin. CO2 laser will tighten your skin as well as stimulate it to be thicker and more elastic. Pre and post CO2 skin care is essential in ensuring a safe result while promoting healthy skin. I suggest following a daily anti-aging skin care program, such as those offered by ZO or SkinMedica.
At around age 40 we lose bone support from our skull and our eye sockets widen; the supportive fat pads in the cheeks also flatten. By age 48, without treatment, this process will have continued. Restylane and other dermal fillers can provide structure and volume where it has been lost. Replacing volume in the mid face supports your tissues, and therefore results in less wrinkles. I recommend injecting all areas of the mid face before considering the tear trough area.  
Finally, Botox - in small amounts - can be used to soften your smile lines. I recommend lessening but still keeping some movement for your smile lines. We all have lines when we smile, and I am sure you have a beautiful smile that your friends recognize as part of your face! We don't wish to change your appearance to that of a stranger. We just want to keep things natural and refresh, revitalize and rejuvenate!
In summary, our ideal treatment plan would focus on healthy skin from skin care and CO2 laser treatments, then on replacing lost structure and volume with dermal filler, finishing off with a smoothing of your smile lines with Botox.