Botox or under eye fillers for wrinkles under the eyes?

botox may help if the wrinkles appear when you smile otherwise lasers, fillers, micro needling and peels are needed.
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.

These are a common reason for people to come in. You really may need a combination of both. There is also some other skin tighten techniques we can add to help really smooth things out.I have even done a lower lid skin pinch in patients that want them GONE GONE.In most patients they are from a combination of skin excess, skin inflammation and volume loss. So you can imagine to tackle these most naturally we need to approach it from a multi-factorial standpoint. Best,DrC

Thank you for your question.  Great results for the eye come from combination treatments.  Aging in the eye area is related to thinning of the skin, changes in muscular contractions, and changes in the orbital bone structure, which unfortunately, start to become visible in our early 20’s.  Using combination modalities will address all of these concerns. Botox ® may help with fine lines.
We can use dermal fillers in small amounts to correct any volume loss in the area.  When volume is restored, skin reflects light better and has a more radiant glow. It is also important to use an eye cream containing a retinoid, hyaluronic acid, and caffeine, which will provide immediate hydration to the skin, and help thicken and restore skin with consistent daily use. We prefer the Illumine Eye Cream from Sente.  You could potentially be a candidate for laser resurfacing or microneedling of the eye area.
In our practice we have more than 45 lasers that we use, sometimes in combination together, to help our patients achieve their goals. We always recommend the combination of multiple treatment modalities to get the best results for each of our patients. Please consult a board-certified cosmetic dermatologist near you who can provide a formal assessment on best managing this delicate area.

Hello, and thank you for your question!
You are not alone, many people are displeased with wrinkles under their eyes.  Botox would not be my suggestion at all.  I typically treat patients with a technique that I call "Aesthetic Facial Balancing."  You may think you don't want fillers, but please understand all filler interventions are not equal and all fillers are not equal.  The results last for years.  In this technique I use the body's own fat, hyaluronic acid based fillers, or allograft materials to rebuild the natural periorbital soft tissue of youth which creates a refreshed and beautified appearance and can make wrinkles disappear.  

I hope this helps!
Wishing you fantastic results,
Dr. Rian A. Maercks M.D. 

Lower eyelid wrinkles are the result of movement over time, volume loss and thinning of the skin. How significant each factor is determines the treatment needed.A good lower eyelid cream containing retinoic acid is a good start for you.Botox is great at decreasing movement and folding of the skin in this area and a good treatment at this time.When lines are present at rest not just with motion a more aggressive approach becomes necessary. This can be in the form of  radiofrequency such as Exilis ME, chemical peels or laser resurfacing depending on how much improvement is needed in the skin.Seek out a board certified plastic surgeon to evaluate you and start you on the right regimen for you.Good luck and I hope you found this helpful.

why fill in creases when you can just get rid of them.  TCA peels or fractora RF gets rid of them nicely and quickly.

Hi, thank you for the question. Under eyes can result from different reasons and its treatment requires combination approach. You can start with a good HA based moisturizer and retinol cream. Combination of botox with chemical peels or skin re surfacing with energy based devices like Fractora RF/ Venus legacy can be beneficial. I would recommend you to have in person consult for further evaluation to achieve optimum results.
Best Regards,
Dr. Neel Bector

A small amount of Botox or Dysport may help with the lines under the eyes. This should be combined with an good eye. Microneedling with or without PRP, fractionated radiofrequency (Ematrix/Sublative) or fractional lasers will also help.

There are many options to help improve the look of the under eye area.  Often times a combination of treatments will yield the best result.  I encourage you to meet with an expert injector near you for a consultation.  Some options that may be discussed are fillers to improve contour irregularities, and treatments such as lasers, chemical peels, or microneedling which can improve skin tone and texture.  Certainly you will want to use medical grade skin care products and swear sunscreen every day.

Thank you for your question and for sharing your photograph Mkitea. I understand your concern. Botox is a purified protein used to address wrinkles associated with facial expression. When injected into the skin Botox will relax the muscles and smoothen out the overlying wrinkles. The most common areas of treatment are in the upper face. These include the horizontal lines seen on the upper forehead when one raises the brows, the vertical lines seen between the brows when one frowns (frown lines), and the crow's feet seen around the eyes when one smiles.
It is difficult to make an assessment without a formal exam in the office where I can view the skin in multiple angles and observe wrinkles formed with facial expression. However, I hope the information provided here is useful.The pivotal studies used 24 units of Botox (12 units per side) to address the crow’s feet. These studies demonstrated that the peak results are seen 14 days after the treatment and most people enjoy their results for 3-4 months. At that point, a maintenance treatment is recommended. While some people start to see results as early as the next day, it can take two weeks for full results so patience is important. We have our patients return two weeks after their treatment to assess their results via photographs. At that time additional units may be added if necessary. 
Botox and fillers are two dermal (skin-related) products are both very popular for their anti-aging features. Unlike Botox, which relaxes muscles to smoothen out wrinkles associated with facial expression, fillers restore lost volume in various areas of the face and body. Common fillers include the Juvederm family (Juvederm Ultra, Juvederm Ultra Plus, Voluma, Vollure, and Volbella), the Restylane family (Restylane, Restylane Lyft, Restylane Silk, Restylane Refyne, and Restylane Defyne), Belotero, Radiesse, Sculptra, and Bellafill. With age changes occur in the bony structures as well as fat pads, both of which contribute to a youthful appearance. Over time bones move and change shape while fat pads get smaller by losing volume and move downward. Fillers restore such lost volume. Common areas of volume loss include the temples on the sides of the face, the upper cheeks, the tear trough area under the eyes, the nasolabial folds which go from the sides of the nose to the corners of the mouth, the marionette lines which are the continuation of the nasolabial folds to the jawline, the chin, and the jawline. Often times combining fillers with Botox treatments yields superior results.
A common misconception is that Botox is only for those who are in their 60's or 70's. On the contrary, I have a lot of patients in their 20's who receive Botox. This is either for prevention or for those who have expressive faces. I find that the younger one is when one starts receiving Botox treatments the more signs of aging will be delayed. In other words, Botox can be used to prevent wrinkles from either appearing in the first place or from getting deeper over time.If I had a patient with the concern described here I would likely recommend a combination of a good eye cream, a small amount of Botox under the eyes, a filler such as Vollure under the eyes, and fractional laser resurfacing to address the wrinkles.With any injection, there are risks such as pain, bleeding, bruising, redness, swelling, tenderness, and infection. We take special precautions to minimize these risks such as using a painless technique. We also treat bruises with a laser as early as the next day. Bruises usually resolve within two weeks if untreated. After a laser treatment bruises usually resolve in 1-3 days, but may still take two weeks for full resolution. In addition to these risks, with Botox there is also a risk that the product spreads or diffuses to nearby structures. Spread to nearby muscles can lead to side effects such as the temporary appearance of droopy eyelids or a temporary asymmetric smile.

After a Botox treatment, I recommend that my patients avoid heat exposure, alcohol consumption, and strenuous exercise for 24 hours and not lie down flat for four hours. This is because all of these activities may possibly lead to the movement of the product and consequent side effects such as droopy eyelids. Although there have been no definitive studies shown that these actually occur and some physicians do not provide such aftercare instructions, in the absence of data I err on the side of caution and recommend that my patients avoid such activities.

Please consult with a doctor for specific recommendations. Good luck!