Under eye wrinkles getting worse. Will Botox or fillers help? (Photo)

A combination approach is often best to treat wrinkles around the eyes.  Botox is best to treat the crows feet wrinkles at the sides of the eyes.  Filler can be used to correct the tear trough line by the nose.  And finally, treatments like Fraxel and Ulthera can be used to help tighten the skin.  You should make a consultation with a board certified doctor who specializes in this area.

A combination approach will give the most improvement. Fillers, lasers, and microneedling/PRP can improve under the eyes. My patients try to get non surgical treatments to avoid surgery. We use PRP and stem cells there often. I suggest consulting with an expert to develop a treatment plan best suited for your short and long term goals. Best, Dr. Emer

You need to be particularly careful having Botox injected into the lower lid. Often a better treatment is filling the eyelid-cheek junction...with Restylane (dont use thicker HA fillers for this) or with natural fat transfer....which works great.

Thank you for your question and for sharing your photograph.  Based on your narrative and photos, you appear to be a great candidate for Botox and possibly fillers.  Beautiful and natural results can be achieved.  Please be sure to see an expert injector for an in-person consultation to fully discuss your goals and expectations in order to determine the best treatment plan.  Hope this helps and best wishes! 

Thank you for your question and sharing your photo.  For your crows feet treatment, botox is the best option for you.  As for your under eyes, filler injections can help with some of those lines correction. It is best for you to get a full evaluation by a board certified and experienced doctor prior to any treatments. Wishing you the best luck.

Hi Angela,
Under eye wrinkles start to form when we loose volume under the eyes.  It is not uncommon for that to start happening in your 20s.  You are just more attuned to it than others.  So kudos to you.  Best treatment for that area are HA fillers in the tear tough area.  Look it up here on RealSelf and you'll get a ton of information about it.  My videos below go into great details about the tear trough area and other sites.  Take care, Dr. Onir

I would recommend starting out with botox and a good eye cream that contains hyaluronic acid.  From there you may consider adding other treatments for further improvement.  Consult with a board-certified and experienced cosmetic dermatologist.

Your best choice for the correction of undereye wrinkles and crow's feet is Botox. See a board certified dermatologist who is experienced in the use of the material

The crows feet wrinkles will respond to botox. the under eye hollowness can be treated with a thin dermal filler. the wrinkles directly under your eye.can be treated with PRP or skin tightening. In my office we use exillis or the lutronic infini.  You should be on a good eye cream that contains retinol and hyaluronic acid.

Thanks for your question.
I am embarrassed by some of the "canned" answers you have received thus far. 
Here is an answer with some thought put into it. 
This is a very common area of concern for women of all ages. Botox and fillers are generally not the answer for what is shown in your picture. The approach to this area, in my opinion, is as follows:
1. Protect your collagen-
     a. Protection from UV rays year round- be vigilant in your use of sun protection
     b. Topical antioxidant- example: Skin Better Science recently came out with Alto Defense Serum- 19 high potency antioxidant ingredients- we are impressed with this one.
2. Promote new collagen and elastin formation - you need to put back what has been lost. Chemical peels alone will not do this for you. 
     a. Consider a topical growth factor product- ex: FactorFive Eye/Lash cream
     b. Start retinol now-you are at the perfect age. (Not Retin A, that is different). Skin Better Science has a very good retinol called AlphaRet Overnight cream. Alastin also has a good one- Renewal Retinol 0.5. 
**Be aware that the vast majority of products you see in department stores, salons and online which claim to have retinol don't really contain enough of it to have the clinical effect you are looking for. Don't get scammed and don't rely on before and after images online or supposed testimonials. Don't assume that it must be good just because it is "pricey". They are often just glorified moisturizers at best. 
Connect with an aesthetic practice that can point you in the right direction with product selection. 
     c. A variety of procedures can stimulate the formation of new collagen in the skin. Consider especially microneedling with PRP- the "Vampire Facial". Other procedures using energy (ex: Pelleve) are also effective. PRP can also be placed into the tear trough region by injection. This should be done by an expert of course. 
3. Since you are smiling in your photo it is not possible to evaluate your tear trough as to whether you could benefit from filler. However, putting filler under the eye will not change the eyelid wrinkles-so if that is your main concern then filler is not your answer.

Best,
Lisa Vuich, MD