Thanks for your photos... consider using Retin A or light laser as both would have a beneficial effect on smoothing the skin. You really don't have any major excesses or bulges and would advise against using fillers anymore (since you had your lower lids done). I'm not familiar with Elactiscin but if you don't think its working (you could only try it under one eye), why waste the $200 when Retin A costs around $50 a tube in my office.
Given that skin quality (including wrinkles) is such a 3 dimensional issue, 2 dimensional photos make it tough to render an accurate answer to your question. It may be that a more aggressive laser peel would give you the results you are looking for (fractionated ablative). Your problem is a common one. The eyelid skin is so thin that you see wrinkles you wouldn't notice elsewhere despite everything else you are doing. Make an appointment with a well respected specialist in your area that has laser experience and see what he or she says. Good luck.
You will get the best information with a consultation with a oculoplastic, facial plastic or general plastic surgeon. However, it doesn't look like surgery would address your concerns. You seem to have some darkening of the skin and fullness that may be due to the filler. Ask your doctor's opinion, but this can be dissolved with hyaluronidase. Then, you may consider CO2 laser resurfacing. This can address fine lines, improve skin texture (wrinkly skin), as well as tighten the area, as well!
Juvederm is a hyaluronic acid filler that is described as smooth. This is also means "runny." In many places in the face, this characteristic to spread out is helpful because it reduces the incidence of bumps. However, this is not good for the lower eyelid. The photo of the left lower eye shows a raised area that is consistent with Juvederm spreading. This material needs to be removed with hyaluronidase enzyme before deciding if something else is needed.
I do not think that you should have a CO2 laser resurfacing. This is really not an ideal method of firming the lower eyelid skin. In my opinion, I would start by having the excess filler removed.
Hope this information is helpful.
Loose skin in lower eyelid
Proper evaluation of each individual patient is required before a specific
treatment modality can be recommended. Some patients could benefit from skin
excision, while other’s could get an undesirable result from that. Some
patients require a skin resurfacing with Laser, while others could get some
pigmentary or other healing issues. In your particular case, with your prior
history, most likely you could be a candidate for CO2 laser resurfacing of your
lower lids. Make sure you seek out an experienced blepharoplasty surgeon that
could properly evaluate and treat you.
You might try a CO2 laser for your lower lids. At this point, I don't see enough skin to justify more surgery but the laser peel would tighten things up and with relatively low risk. You will need to avoid sun for at least a month and expect significant redness for at least that long. Good luck
I like to refer to the looseness of skin under the eyes, like you have, as 'crepey' skin- eyelid skin is quite thin as we age, the skin under the eyes stretches and appears loose. It looks like you have tried many options, and those are all reasonable treatments- they all treat different aspects of the same problem.
-Botox stops the muscles from moving, so when you smile or animate your face, the area under the eyes does not appear 'wrinkly'.
-Juvederm or other fillers are great to fill in the transition area where the eyelid skin becomes cheek skin, camouflaging the 'bags' and makes the eyes appear less tired.
- You mentioned your had a lower bleph (lower eyelid procedures), I assume they removed some of the protruding fat under the eyes, this further makes the eyes appear less tired.
- The best option for the 'crepey' skin is to perform some kind of resurfacing procedure, what that does is remove part of the top layer of skin- the epidermis- and stimulates it to regenerate with newer tighter, less crepey appearing skin. The deeper you go with the resurfacing, the better the results. I usually perform a CO2 laser resurfacing of the lower eyelids for the best results. I do tell my patients that there is about a week of downtime, with some peeling of skin, like with a sun burn, but the results are wonderful.