Under eye wrinkles - no results after Ultherapy and Botox. What else could I try? (Photo)

Based on your photos I think you may benefit from additional volume in the undereye area. If you're hesitant about surgery, you could try a hyaluronic acid filler first to reduce the depression and hollowness along your lower lids and cheek junction. You do have some peri-orbital wrinkles (crow's feet) as well that would benefit from continuing on with your Botox treatments.

Morpheus 8 is a non-invasive skin and soft tissue tightening treatment that is consistently amazing in our patients. We use the Morpheus to exact fractional induced RF into the skin or tissue in order to tighten collagen and stimulate contraction of the tissue. For acne scars, it is quite useful to build collagen in patients who have atrophic scars but is not very productive for ice-pick scars which require TCA Cross. For tissue tightening, Morpheus is ideal for the face and neck and we often combine it with CO2 laser or Ultherapy to further enhance results. Chemical peels and skin resurfacing should be done at least 5 to 7 days after, but can be performed earlier, depending on treatment severity. Avoid exfoliating skin treatments before Morpheus and expect a period of 2-4 weeks for skin contraction to set in.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Hi Rinochka,
Thank you for your question. Based on your photos, you may be a candidate for periorbital rejuvenation with either HA filler, CO2 laser resurfacing, or a combination of both. Please reach out to a board eligible or board certified plastic surgeon for an in person consultation to discuss your options. Hope this helps!
Charles Riccio, MD

Hello! My name is Jessica, I am a physician assistant, and one of the providers at Aesthetic Skin. This is a great question. I recommend treating the area of concern with several sessions of CO2 laser resurfacing. However, I highly recommend scheduling an in-person consultation in order to better assess your areas of concern and discuss an appropriate treatment plan to help achieve your aesthetic goals. Our office phone number is: (312) 944-0117, just call and ask for Jess :) I hope this helps and best of luck!

At least from the photos provided, the primary problem is one of under-eye hollows. So no surprise that the Botox didn't work, since it is best used when there "jelly roll" infraorbital muscle hypertrophy is an issue. Also no surprise that the energy-based treatment didn't work, since I have been cautioning my regular followers for years that the hard science to back up the use of all the expensive, so-called "next big thing" devices out there lags well behind the heavy marketing hyped and social media buzz to promote them. Sorry. The good news is that the use of an appropriate low viscosity, malleable, cohesive HA filler has a proven track record for treating under-eye hollows and tear troughs. You would be wise to consult with an experienced, board certified cosmetic dermatologist and exercise a great deal of "buyer beware" caution if offered any more energy-based devices going forward. Hope this helps and best of luck.

A couple of options to consider are fillers to improve overall contour of the under eye and Morpheus8. This treatment combines RF technology with microneedling to improve overall skin tone and texture. It is safe to use around the eyes. Treatment is done in the office with optimal results after three treatments. See my website or a provider near you to learn more.