Under eye wrinkles, hollows and dark circles. What are my options to restore youth? (photos)

My eyes show my age (42). What are my best options? These pictures don't show it well, but there is also significant fat loss below lower outer corner of the eye that has large wrinkles under it. (Pics are 1 week after botox in crows feet and frown lines. ) I don't have the ability to have long down time and I'm not sure I would be able to withstand lots of pain - especially for a long duration.

Doctor Answers 7

Correction of Hollow eye deformity

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Thank you for your question.  Although Restylane can be used to correct the Hollow eye, Arcus release and fat grafting is a more permanent solution.  Please read the link below to understand.

To rejuvenate the eye area, use Restylane and consider skin tightening with the Infini RF

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You have loss of volume around the eye which is best treated with Restylane.  I would recommend using someone that uses blunt cannulas for this injection so the chance of bruising or complications is reduced.  For crepey skin around the eye, I would use the Infini, which is a new microneedling RF device.  Botox might help as well.  I written a blog all about this very situation, see below.  Steve Weiner, MD, Facial Plastic Surgeon, Destin, Florida.

Steven F. Weiner, MD
Panama City Facial Plastic Surgeon
4.8 out of 5 stars 53 reviews

Restylane for eye hollows

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I think that a filler , like Restylane, would do exactly what you want. You might get some bruising but otherwise it is very simple.

Rejuvenating under the eyes

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RF (Radiofrequency) is helpful for the wrinkles, but may take multiple treatments depending on severity of the wrinkles and healing. The IPL and 1064nm Yag laser is best, in my experience, at getting undereye redness and blue/purple veins.  Filler is helpful to lift a hollowed under eye, and fill a tear trough groove, and mask some of the darkness, and I would recommend hyaluronic acid fillers for this - like Restylane, Perlane, Juvederm, all of which I have used with success in this area.  In addition, a little Botox in the mid lower eyelid will help to open the eyes better, and reduce a roll of skin that many of us have in that area.

Nowadays, physicians tend to advise the device that they carry in their office, and due to the high cost of these devices, the average cosmetic physician will have only one or two devices to choose from for a given cosmetic problem.  Another factor, is the physicians skill and experience with the device.  At my office, we have over 48 cosmetic devices, and conduct research of these devices for cosmetic treatments.  We have had the most success for mild to moderate periorbital wrinkles with repeat treatments 3-5 of RF or a single more intense treatment (and more downtime) with either fractionated CO2 or Erbium/CO2 laser.  We have also succeeded at eye wrinkle tightening with the gentle Fotona Yag laser, 3-5 treatments, with less downtime than RF, but crucial that it is done by a skilled laser surgeon, as Yag lasers can cause blistering/scarring in the wrong hands.

Karen Stolman, MD
Sandy Dermatologic Surgeon

Treatment for under eye hollowness and darkening

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I think that you would see the most benefit from Fat transfer under your eyes and skin resurfacing with a fractional CO2 laser.  There is little pain from this procedure and the recovery period is about 5-7 days.  Botox to the crow's feet is also a good start.  Restylane injections work well also but the results will fade in about 6 months.

Carey Nease, MD
Chattanooga Facial Plastic Surgeon
4.0 out of 5 stars 24 reviews

Restylane for Volume Loss Under Eyes

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Hi Katie.  You are an excellent candidate for tear trough injections under the eyes.  This service is great for patients that do not want to consider surgery, but have volume loss or genetics that cause the under eye are to appear concave.  This concavity can make the area appear darker and contribute to a tired appearance.  Restylane is excellent as a remedy.  Click on the link below to review photos that address the issue with Restylane injections.

Harold J. Kaplan, MD
Los Angeles Facial Plastic Surgeon
4.4 out of 5 stars 7 reviews

What are my options for my eyes?

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From the pictures that you have provided, you look great!. You do have a bit of hollowing in the tear trough region which is the region of the eye next to the nose. You may consider Restylane as a minimally invasive treatment option with virtually no downtime and little discomfort.

Todd C. Miller, MD
Newport Beach Facial Plastic Surgeon
5.0 out of 5 stars 34 reviews

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.