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

Hi GoGo.  While we have the option of suggesting injections, lasers or surgery at our practice, for you, we would recommend surgery first because of the amount of excess skin and laxity (looseness).  Lasers and injections are an option if you are absolutely unwilling or unable to consider surgery.  In this case, we would recommend a fractional laser resurfacing procedure like the Sciton Profractional and an injection product like Restylane.  Even with both of these on board, we would have very realistic expectations as it looks like the skin bunches up under your eyes when you smile.

A lower blepharoplasty surgery would be our first recommendation.  Good luck.

You might have improvement with a pinch of skin being excised by an oculoplastic surgeon followed by erbium laser treatment. Good luck!

There are various lasers and treatments such as botox that can used to treat wrinkles. I would advise you to schedule a consultation with a board certified plastic surgeon for a detailed examination to discuss all possible treatment options and what your expectations are. 

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

A combination approach will give the most improvement. Fillers, lasers, and microneedling/PRP can improve under the eyes. My patients try to get non surgical treatments to avoid surgery. We use PRP and stem cells there often. I suggest consulting with an expert to develop a treatment plan best suited for your short and long term goals. Best, Dr. Emer

Thank you for your question regarding skin laxity and wrinkles.  It is difficult to accurately suggest the exact treatment without an in person consultation.  If your issue is fine lines and a few wrinkles, botox could be the solution for you.  If you have a greater degree of skin laxity you may need a lower blepharoplasty.  This is a surgical procedure when excess skin is removed.  Other options could be injectable fillers,or laser procedures.
I would recommend seeing a Board Certified Provider to make sure you receive the best procedure for your concerns.  
Hope this helps!

When it comes to fine lines under the eyes, the best method to use is the laser. The laser that would work best for you is the Fractional Laser. This type of laser stimulates the collagen production under your skin, In our clinic we recommend getting between 3 to 5 treatments. Botox will not help under the eyes, because it is used for other areas in the face such as crows feet lines and Fillers are only helpful if you have loss of volume. The Fractional Laser fits your situation perfectly. 

In certain patients, any of these might be the right answer. Based on the photo provided, a combination of blepharoplasty surgery and/or laser treatment such as fractional CO2 might be the best options. Fillers like Restylane are unlikely to improve the skin laxity and muscle activity seen in the photo. Botox is an option for lower eyelid wrinkles, but can sometimes worsen the overall appearance of the lower eyelid complex. A good skin care regimen is also important and can be focused to address the problem areas of the lower eyelids as well.
All the best,

As women reach their late 30s and early 40s they start seeing more wrinkles under their eyes than ever before. This appearance is very bothersome for many women, but luckily there are a few treatment options available to help decrease and remove the appearance of these wrinkles. In my practice I usually recommend Restylane under the eyes or Voluma in the cheeks to restore volume and create a naturally youthful appearance. If fillers will not do enough to improve the appearance, then a surgical lower eyelid lift (blepharoplasty) may be best to truly give you the results you want. While you did provide a picture of your eyes, I like to examine a patient's entire face, as I take a more comprehensive approach when treating the face and want to make sure whatever treatments I perform make the entire face look better. The best and most natural looking results are achieved when we take a holistic approach to facial rejuvenation. Good luck! 

Thank you for your question and for sharing your photo. Botox may help to soften the wrinkles under the eyes. It does require a very small amount and it will help to soften the lines. It will not necessarily reduce all the wrinkles like you might see in the forehead or crows feet region. You will notice a soft relaxation of the dynamic lines under the eyes, and you may notice a slight opening of the eyes. I would start with 1-2 units under the eyes on each side. If you like the effects, then it is very easy to incorporate this into your future treatments. Dermal fillers such as Restylane can be used to fill in shadows under the eye and achieves a more rested look. You can combine the two treatments but it would require a thoughtful approach and careful analysis of your concerns to ensure that treatment options will help you achieve your goals.I would recommend visiting with a board certified plastic surgeon in your area to address your concern as it is an advanced area to treat.  In addition, a plastic surgeon will be able to discuss surgical alternatives.