Dark Circles, Eyelid Wrinkles/Bags Treatment -- Restylane or Belotero with Cannulas, Clear+Brilliant, Eclipse Micropen, Viva
A combination approach with lasers, fillers, skin care and microneedling/PRP for treatment of under eye wrinkles yields optimal results. I suggest continuing on your skin care and treatment regimen and adding microneedling/PRP with Clear + Brilliant. I suggest you speak to your dermatologist for the best long term treatment options that are individualized to your own skin. Best, Dr. Emer
Treatment of Fine Lines from Sun and Smoking
You are definitely on the right tract. You need to make sure the sun block you use is a zinc oxide one of at least 8% and that you use it every day and reapply it if you rub or wash it off. I would also switch from Refissa, as it contains mineral oil which reduces or prevents the absorption of the tretinoin (the retinol) and, thus, markedly reduces the ectiveness of it. You did not say whether you have quit smoking. If you have not, you absolutely must do so or you will never improve the lines. Filling any deep lines and using Retin-A can, over a year or 2, significantly reduce the lines as long as you remove the muscle component with Botox. A peel or laser can significantly speed the process if the other things you are doing are optimal. An Erbium laser is not, however, a good choice. Make sure you see someone who is an expert in skin rejuvenation to guide you through the process.