I'm 27 year-old with lax crepey skin and wrinkles under eyes. Restylane, Juvaderm, or Laser Treatment? (photos)

Question

I've always had under eye wrinkles when I smiled. Last year I realized how wrinkly, thin and crepey the skin under my eyes look. I aged 5 years in a span of a year. When I apply concealer the wrinkles are even more noticeable. I'd like to know if Restylane or Juvaderm would help in my case. I have a good skin regimen, but I'd like to know what eye cream I could be using under my eyes to make the aspect of my skin better. I use a shiseido one, but I didn't notice any difference.

Jeff Rapaport, MD · Answer

In my opinion, the fine lines under your eyes are not very deep. I would first begin with topical therapy, most likely a retinoid such as Retin A. You can also consider some of the newer OTC medicines that act to tighten the under eye skin. If you are not satisfied, you can consider a very mild superficial filler such as Restylane silk. Radiofrequency tightening is probably overkill and laser is not appropriate at this time. Please consult with a doctor who has experience and will show you pictures. Hope this helps. good luck.

Raffy Karamanoukian, MD, FACS · Answer

Fractional CO2 laser is an excellent tool for skin rejuvenation in our center in Santa Monica. We use the fractional multi-depth ablative approach to help resurface the skin, recontour acne scars, improve incisional plastic surgery scars, and reduce surface irregularities from skin tone to dark pigmentation. Our approach utilizes a multi-depth approach that targets melanocytes in the epidermis and collagen fibroblasts in the dermis. This approach can be combined with a TCA Peel in a process known as a sapphire peel. Fractional laser is excellent for acne scars and contour scars in the skin. Patients are advised to undergo skin protocols with Melarase creams before and after treatment to help reduce pigmentation. Melarase AM, Melarase PM, and Melapads can seriously improve surface sun damage and UV related pigmentation. After the laser, we expect redness for a few weeks as the skin improves. PRP and Hydrafacial enzyme facials can further improve skin quality after fractional co2.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best,
Dr. Karamanoukian 
Realself100 Surgeon

Jason Emer, MD · Answer

The eye area needs significant combinations to get improvement. Lasers like erbium, co2, halo, profractional/contour, or Fraxel can all be used to build collagen long term. Plasma pen is a newer less invasive option but will take many treatments and require proper skincare. Plasma Pen is focused electrical plasma energy to tighten skin, producing small columns of energy just above the skin, allowing the skin to tighten to help improve wrinkles. This area will have 3-5 days of small “dots” that will then scab and peel, then the skin will tighter and brighter after. Numerous treatments are needed over lasers where only one or two give a bigger result, but more downtime. After plasma pen you NEED peels 2 weeks like later Cosmelan, enlighten or aerify, see emeragecosmetics (link). At home derma rolling should be started weekly even after plasma pen or lasers to further increase collagen, see emeragecosmetics AERIFY x anteagemd stem cell ampules. To properly heal you need light Stim red LED, EmerageSkin refit face, refit eye; AnteageMD serum, silagen silicone gel, jan Marini bioshield, EmerageSkin enzymatic polish, and EmerageSkin hyla b and AOX, and Sente dermal repair. Otherwise there is EXTREME risk of pigmentation issues and “dots” in the treatment area. at home peels like cosmelan, enlighten and aerify along with dermarolling (AERIFY emerageskin roller with Anteage MD ampules) should be started now regardless for antiaging, sun damage, and wrinkle prevention. There are many things you can do to treat under eye hollows and dark circles. A surgical option to remove skin and/or fat will such as eyelid blepharoplasty with or without fat pad repositioning (if doing lower eyelid surgery) will be the best long term. There are many things you can do to treat under eye hollows and dark circles without surgery. Non invasive less downtime options such as fillers, lasers, microneedling/PRP, cosmelan peels, and microneedling RF like Fractora, PiXel8 or morpheus can all help give some improvement. Accutite can often be used or stronger lasers like erbium or co2 spot treatment can tighten the skin and give very quick improvement in wrinkles and texture. I suggest you get a formal consultation to see what is best for you and your goals. Best, Dr. Emer.

Nelson Lee Novick, MD · Answer

Without wishing to trivialize the importance to you of the crinkling problem under the eyes, I would suggest only the most conservative management right now. This might include the use of a tiny droplet of Botox (or Dysport or Xeomin) placed directly into the belly of the "jelly roll"-like muscle that stands out a bit with the smile. In my experience this can help alleviate the hypertrophic muscle and the crinkles that stand out with facial expression. Aside from that, you would do well to moisturize and use sun screen regularly to protect the under eye area.

Brett S. Kotlus, MD, MS, FACS · Answer

You have youthful-looking eyes and you shouldn't do anything drastic at this stage.Visit with an oculoplastic or facial surgeon or a dermatologist to have your skin type evaluated for professional advice on topical treatments.  Since your lines seem to appear when your are making expressions, fillers may not be the best option for you right now, but a small amount of Botox or Dysport can soften some of the dynamic creases that are appearing at the outer corners of your eyes. Good luck to you.

Payman Danielpour, MD, FACS · Answer

I understand that your perception is subjective but in my opinion and after looking at your pictures, I would recommend that you hydrate and use good moisturizer and skin care and possibly a vitamin C serum.  You dont look like you need fillers or laser, at least not now.

Medical Relations - SkinCeuticals · Answer

Please consult a board certified physician if you are considering the use of any in-office procedures to address your under eye concerns.For at-home treatments, we suggest looking for a product formulated for the delicate eye area with a potent combination of proxylane, blueberry extract, and a complex of flavonoids and synergistic peptides. These can be found in SkinCeuticals A.G.E Eye Complex, a multi-dimensional eye treatment formulated to improve the appearance of dark circles, wrinkles, puffiness, and crepey skin caused by glycation. Glycation occurs when excess sugar molecules bind to collagen and elastin fibers and weaken the skin’s underlying support structure. This rich, dry-finish balm immediately boosts eye-area radiance while visibly improving firmness and elasticity for a more well-rested appearance. In a 12-week study, A.G.E. Eye Complex significantly improved the appearance of key visible signs of aging.

Darryl J. Blinski, MD · Answer

So very minor an issue! Try Restylane silk just release for these areas. Cost $600 per syringe.........

Mark Taylor, MD · Answer

You are young and beautiful and your wrinkles are very mild!  Start with a good eye cream. If the eye cream is not enough, I would recommend some light chemical peels, microdermabrasion or some light laser treatments with the Clear and Brilliant Laser.   Good sunglasses and sun protection will also help retain your beauty.   Don't do anything too harsh at your young beautiful age.

I'm 27 year-old with lax crepey skin and wrinkles under eyes. Restylane, Juvaderm, or Laser Treatment? (photos)

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