Age 35, under eye lines - Laser? Filler? Surgery? (photos)

The best option to improve those fine wrinkles would be either a laser resurfacing or a chemical peel. These will improve those lines, but nothing will make them go away completely. A surgery for the lower eyelids may improve this as well, but it is generally designed to improve the "puffiness" of the lower eyelids. I would start with a skin resurfacing technique like I mentioned above and see if this improves things enough.

Your photographs are somewhat limited. I recommend an extended brow lift. This will pull the eyebrows higher and pull the temple area back. This will take care of the crows feet and wrinkles around the eyelids and lift the eyebrows to a more normal position. You can then consider a blepharoplasty after the extended brow lift, if necessary.

Best Wishes,

Gary Horndeski, M.D.

The changes in your lower eyelids are very common and consistent with age appropriate aging. Hyaluronic acid fillers can leave your lower lids too full as they pull in water and are hydrophilic. A biostimulator would be preferable. I use EZGel which is platelet rich fibrin that naturally reverses the aging process and fills by stimulating new collage production.

The lack of volume in your midface is based on your facial, skeletal structure, which is genetic.
Worsening of wrinkles is due to loss of skin elasticity which comes from age and sun damage ( neither is reversible).
Personally, I’m not a fan of facial fat transfer, especially around the eyes.
I have found the facial fat transfer to be inconsistent and potentially unforgiving if patients don’t like the outcome.
There is probably no good way to get rid of the wrinkles. If there was a successful treatment for this, we would all be doing it.
The best treatment for restoring midface volume (if you wish to do that) is fillers.
For volume restoration check out the website of Dr. David Mabrie, MD in San Francisco.
His work is the best I’ve ever seen.
I’m not suggesting people fly to San Francisco to get fillers, but understanding what this treatment can accomplish can be a powerful tool in finding the right providers.
I wish I could be more optimistic regarding treatment options, but I think your best option is to save your money, wear sunscreen and avoid excessive sun exposure.
This is a fairly complex, anatomic area and treatment is not easy or straightforward.
Best,
Mats Hagstrom MD

Skin wrinkles so we need to improve skin quality with laser and skin booster injections. Avoid fillers and surgery is not recommended based on your photo.