Restylane: Q&A

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Best Treatment for Under Eye Loose Skin and Wrinkles? (photo)

Can you please advice on the best treatment for my under eye loose skin and wrinkles. I am 40 years old, They only form when I smile, but then seems to take over much of my appearance. I have also lost a lot of volume in my face, despite no major weight loss. I have dry eyes and I am also worried about the pulling down of the lower eyelid that seems to sometimes (often?) be the result from lower bleph. I would appreciate your opinions!

16 Doctor Answers | Asked by UWSmom
+2

Best Treatment for Undereye Loose Skin and Wrinkles

Hi U, Properly placed Botox or Dysport will be very helpful. I have found that a combination of first using Ulthera (micro-focused ultra-sound) over the inferior orbital bony rim immediately followed by fractional CO2 laser (Fraxel repair) has resulted in impressive improvement. As you noted, augmenting the volume in your face would also be overall helpful. Most importantly choose your treating physician most carefully. Good luck and be well. Dr. P more
+2

There are a number of ways to treat under-eye wrinkles

Botox can relax the muscles that make wrinkles when you smile. However if you have early or inherited "eye bags" relaxing the muscles under the eyes might make the bags look bigger since the muscle isn't holding the fat back any more. Other treatments include chemical peels, lasers and even surgery. Blepharoplasty is designed to smooth and improve the lower eyelids.
+2

"Non-surgical eyelid lift" will help.

Hi. 1) You have beautiful eyes and I would be very conservative. 2) It does not look like you need a peel or laser. 3) Tiny doses of Botox should relax the laugh lines. 4) Tiny doses of Juvederm Ultra in the tear troughs under your eyes will help with lost volume. see video

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I agree with much of what has already been written. Dr. Atkins in our office, cosmetic dermatologist, has another opinion and after seeing these pictures she suggested these options. The lower lid is thin and fragile, so if you elect for surgery make sure you work with a board certified surgeon that does alot of these procedures. Also ask to see before and after pictures. There are lasers that could help improve the lower lid for... more
+2

Dynamic lines around the eyes

Looking at the two pictures you provided, its appears that most of your wrinkles form with contraction of the circular muscle around your eye when you smile. Botox and Dysport injections both work well to reduce the movement of outer part of your muscle to soften the appearance of those lines. From the picture you have provided, it is hard to assess the volume loss in your face that you mentioned. There are many fillers such as Restylane and Juvederm that are great for... more
+2

Botox for dynamic wrinkling about the eyes, but smooth that crepey skin with a peel

Botox will smooth lines around the eyes that appear when you talk, smile or animate. This is one of my favorite areas to treat because the eye still narrows when you smile -so you look natural, like you're smiling with your whole face. But the corner just doesn't wrinkle up. That being said, the skin under the eye, being the thinnest skin on the body, thins further with age and takes on a crepey appearance. This crepey skin wrinkles even more easily when... more
+2

Best Treatment for Under Eye Wrinkles When Smiling

Your description of the issue and photographs are very useful. As Plastic surgeons we were trained to approach each person we see by considering a "ladder" of potential solutions (where the lowest and safest rung is doing nothing, the one above is the simplest / least risky yet least likely to result in drastic changes and so on) contrasted to a scale of benefits VS recovery and complications for each treatment. In your case, I completely agree with my friend Dr. Rand. Careful use of... more
+2

You can't treat animation artifacts with surgery

You are correct in that your lower lids are a very fragile area and need to be treated with the utmost respect as any aggressive treatment can lead to disasterous complications. The only thing treatments like surgery and lasers can do is to make you look good at rest - but you already do. The best thing to do for your animation artifact is to use some judicious Botox to soften the strength of the muscles causing the wrinkles. But realize that nobody looking at you smiling... more
+1

Best treatment for under eye loose skin and wrinkles?

An appropriate skincare regimen, resurfacing procedures such as peels and lasers, and finally Botox or Dysport injections can address fine wrinkles under the eyes. During an in-person consult, you can discuss your needs with your physician and he/she will determine the best procedure for you. For restoring volume in the face, the vampire facelift is a great option. For this procedure, we use PRP, or platelet rich plasma. The PRP is injected into the face, just underneath the... more
+1

A Combination of Volumizing Fillers and Neuromodulators Work Well For Under-Eye Crinkles and Wrinkles

The upper inner cheek region, i.e. that inner area immediately under the eye and extending diagonally upward and inward toward the inner angle of the eye, plays an important role in supporting the lower lid. Loss of fat and downward displacement of the remnant of the upper cheek fad pad with age contribute to wrinkling and tear trough formation (and even dark circles) under the eyes. Revolumizing that region nonsurgically with the use of injectable volumizing fillers, such as Radiesse... more
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These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.

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