What treatments do I need for my under eyes? I'm 36. (photos)

Question

I am 36 years old and just have notice alot changing under my eyes . I am seeing alot of thinning of the skin and when I smile my skin is bunching up in the tear trough area. Which is my main concern the bunching up and wrinkles .I'm not sure if it bags or lost of volume idk what I'm dealing with. I know most doctores will probably say I need fillers or botox but what other treatments would be beneficial also ? I'm not sure if I would want fillers quite yet

Nima Shemirani, MD · Answer

Hi @Calm7233! Dermal fillers would be a great option. You can also consider microneedling and chemical peels. Best of luck, Dr. Nima!

Mitchel Goldman, MD · Answer

Filler is typically the first line of defense when addressing signs of aging in this area. However, you can begin with a collagen induction therapy like RF microneedling if you prefer. This treatment uses tiny needles to create micro-channels in the skin, and then delivers gentle radiofrequency heating deep into the tissue to boost collagen levels. While the results take some time to appear, they can be quite natural. I encourage you to schedule a consultation with an experienced, board-certified dermatologist for further assessment and a customized treatment plan.

Jonathan Kulbersh, MD · Answer

While you could address this issue with RF microneedling, your best results will likely come from some tear trough filler. This treatment adds subtle volume under the eye to create a smoother appearance to the lower lid. Restylane and Juvederm are both good choices for this area. This procedure requires precision to achieve an optimal result so be sure your injector is qualified, experienced, and has had ample training in this procedure.

Ramandeep Sidhu, MD · Answer

Hi!

If you aren't quite ready for injectables, I would recommend microneedling treatments. Microneedling has also been referred to as collagen induction therapy. The tiny needles of the microneedling pen create tiny pin pricks over the area treated initiating a wound healing response from your skin which promotes collagen production and helps to smooth fine lines and wrinkles. Microneedling can also be done on your whole face to create a nice facial rejuvenation not only for your eyes. A way to boost the results of microneedling would be to do microneedling with PRP. This treatment uses the platelet rich plasma from your own blood to be absorbed into your skin. Since PRP is rich in growth factors it is a natural way to enhance results. Best of luck!

Jason Emer, MD · Answer

at home peels like cosmelan, enlighten and aerify along with dermarolling (MTS roller with anteage MD ampules) should be started now. plasma pen, blepharoplasty, and lasers can help.

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 be the best long term.  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 be the best long term.  However, non invasive less downtime options such as fillers, lasers, microneedling/PRP, cosmelan peels and stem cells can all help give some improvement. I suggest. You get a formal consultation to see what is best for you and your goals.  Best, Dr. Emer.

Mitesh Kapadia, MD, PhD · Answer

It looks like the main issue is volume loss, which can be treated with filler injections. CO2 laser resurfacing can be used to help improve the fine lines.

Camille Cash, MD · Answer

Fillers would give you a nice improvement by using volume to disguise under eye irregularities.  If you are not yet ready for fillers you can consider treatments such as microneedling, chemical peels, or FaceTite.  See an expert injector near you to learn more.

Ahad Mahootchi, MD · Answer

We can't see what happens when you smile by the pictures but Botox can help the wrinkles that come from animating your face.

There maybe an early festoon so an in person consultation would be beneficial. Lower Blepharoplasty can address some of the issues but the mid face needs to be considered.

Some are trying intra-festoon dilute doxycycline for them.

Best of luck to you.

Ahad Mahootchi, MD

Michael J. Yaremchuk, MD (license resigned) · Answer

It looks like you have tear troughs that are giving you the appearance that you don’t like. Honestly, at your age, the best treatment would be a light particle filler. Surgery including fat transposition is also an option.

Onir Spiegel, DDS, PhD · Answer

Under eye fillers, otherwise known as tear trough fillers, are the best remedy for early hollowness under the eyes that causes those first wrinkles. Look into Hyaluronic acid fillers like Restylane and Versa to get you the best results. All the best from Boston, Dr. Onir