I have wrinkles around the eyes and would like to try some filler. Is Juvederm the best one?

Dear Rosane, If you have superficial or medium depth creases then Juvederm, Elevess or Cosmoderm are good choices. If the lines are dynamic creases which means that they show up mainly only when you smile then Botox is a good choice. There are no allergies to any of these materials and can be injected at your initial consultation very easily. Juvederm and Elevess are similar to Restylane but last alittle longer. (approx 6-9 months) Cosmoderm lasts approx 3-4 months which lasts about the same as Botox. Bruising and alittle swelling or redness is normal and goes away in a day or two. Some patients need both a filler and botox together which can be done on the same day. David Hansen,MD

Fillers are not always the answer. It matters exactly what the pathology is. So if these are fine wrinkles of the lower eyelid then a resurfacing technique such as a chemical peel or a fractional laser is best. If they are wrinkles laterally around the sides of the eyes then these are typically from overactive orbicularis muscle and Botox or Xeomen toxin can be used to paralyze the muscle which will decrease the appearance of wrinkles. Fillers are better for "filling" hallowness, shadows and divots. They do have a roll in larger defined wrinkles but they are really most beneficial to augment adjacent areas that enhance and decrease the wrinkle in that way. DrC

If you are referring to crows feet, botox would be the first go to treatment. If the wrinkles and skin excess is severe many surgeons would recommend a blepharoplasty. Filler is used to treat under eye tear troughs. This is general information, please discuss with your surgeon

Thank you for your question. The right treatment will depend on precisely where the lines are located. Lines around the outer corner of the eyes (crow's feet) are known as dynamic wrinkles because they form as a result of repeated facial movements. These lines are most effectively treated with a neuromodulator like Botox, which targets the muscle that forms the line to smooth it away. If your concern involves the tear trough area, injections of small amounts of filler in this area can create a smoother appearance. I typically inject this area using a blunt-tipped cannula rather than a needle, creating a safer procedure, fewer side effects, and a superior result. Other fine lines under the eye might respond best to a laser resurfacing treatment that stimulates collagen production in the area to create a more youthful appearance. I encourage you to schedule a consultation with an experienced, board-certified facial plastic surgeon for further evaluation and a customized treatment plan.

Thank you for your question! Fillers like Belotero, Volbella, and Restylane Silk are good for improving under the eyes, but keep in mind that a combination approach will give the most improvement. My patients try to get non-surgical treatments to avoid surgery, so we use fillers, lasers, microneedling/PRP and stem cells. I suggest consulting with an expert to develop a treatment plan best suited for you. Best, Dr. Emer

I have used several different fillers for this area, including several from the Juvederm line. I prefer Restylane Refyne for this area as it tends to result in less puffiness in my hands.The foregoing information provided is not intended nor implied to be a substitute for professional medical advice, it is provided for educational purposes only. You assume full responsibility for how you choose to use this information. Always seek the advice of your physician or other qualified healthcare provider before starting any new treatment or discontinuing an existing treatment. Talk with your healthcare provider about any questions you may have regarding a medical condition.

Filler may or may not be the best answer to your concern, wrinkles are usually caused by muscle movement of the face, in which case a neuromodulator would be the best line of treatment. The area to the side of the eyes (lateral, also known as Crow's feet) is best treated by a neuromodulator (Dysport) to address either static lines (wrinkles at rest) or dynamic lines (wrinkles that only present with expression). Lines presenting below the eyes, can be treated with dermal filler (hyaluronic acid) as high as the orbital bone that surrounds the eye can be palpated. This treatment is usually referred to as "tear trough filler" and when done by an experienced practitioner, can yield some amazing and natural results. The two treatments can also be done together. If the skin in the area is still lax, eye creams can help, or a more dramatic result can be achieved with a surgical blepharoplasty. Good luck!

Depending on your eye wrinkles, I would recommend the following: 1) for crow's feet - if only present when you smile or squint, start with a neurotoxin (botox/dysport) 2) for crow's feet that are also present at rest, start with a neurotoxin and also consider a filler (I prefer restylane silk, but belotero or volbella are also options). Can also add on microchanneling or an energy-based procedure such as ultherapy or radiofrequency. 3) for under-eye wrinkles, consider neurotoxin. 4) If you have crepey skin under the eye, use a good eye cream with retinolPlease go to a board-certified dermatologist or plastic surgeon for a proper evaluation.

Hey there! This depends on which eye wrinkles bother you. The small lines that appear when you smile in the corner of the eye area are best treated with botox. Sometimes a little can also help with very mild creases directly under the eye. Otherwise the deeper troughs / eye circles can be effectively treated with dermal filler. So there are many good products available for improvement of the tear trough or eye bag area this is based mostly on clinician preference and technique (syringe injection or microcannular) Personally, I use a different product mostly dependant on the type of tear trough the patient has - whether puffy / hollow / poor mid-face volume . For example improving structure and volume around the tear trough is an important first step. I usually use Juvederm volift / voluma to improve cheek and mid-face volume which can drastically improve the tear trough area in the first instance. Due to the thin and delicate skin in the actual tear trough, vobella or a similar softer filler (some also use Teosyal redensity 2) should then be used. Make sure you choose a clinician with expert experience in injecting the tear trough area / advanced practitioner. Hope this helps and good luck! Dr Rupert

The best treatment for periorbital wrinkles is entirely dependent upon the cause of these wrinkles.Periorbital wrinkles can be caused by a variety of factors.In some cases, wrinkles may be caused by muscle hyperactivity.An example of this would be the development of crow’s feet.Under these circumstances Botox injections would be appropriate.When eyelid wrinkles are related to textural skin changes associated with normal aging, injectable fillers are usually the best treatment option.When this situation arises, hyaluronic acid fillers are usually utilized.These include Perlane, Restylane, and Juvederm.These materials are highly effective and very safe.In most cases, they last up to 6 to 9 months and may last up to a year following treatment.They are currently the gold standard for treating lower eyelid deformities.If you’re considering lower eyelid injections it’s important to consult a board certified plastic surgeon.This surgeon should be able to formulate a treatment plan that addresses your concerns.