It depends on the cause of the wrinkles

If the area under the eyes is sunken in then a filler such as juvederm or fat helps temporarily (4-6 months) to plump it up.  If the creases are worsened when you smile then botox ($300) helps for about 3-4 months.  If the creases are noticeable all the time then a more superficial filler such as collagen or juvederm is helpful ($550/syringe).

Sometimes it is better to just chemically peel ($350/session for 3 session) with TCA or maybe  laser ($750-1000/session) the areas to give a 1-3 yr improvement. Then you can touch up the areas with fillers afterwards if any lines remain.

Lower eyelid wrinkles can occur because of a variety of causes, including:

• Loss of skin resiliency
• Loss of volume
• Reduction in collagen content

In the case of mild lower eyelid wrinkles that are present at rest, the mainstay of treatment is to improve the quality and resiliency of the skin.  This can be done with chemical peels, lasers, or topical agents.  If the lower eyelids have dynamic wrinkles that are increased with animation, a treatment with Botox may provide termporary benefit.

Lastly, patients with moderate wrinkles, skin redundancy, and orbital fat herniation may be candidates for a blepharoplasty or eyelid tuck procedure.

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