Is there a good solution to my hollow under eye area and the creasing created by smiling? (photos)

Thank you for your photo and yes placement of filler is extremely important to get the flushed look under the eye. Seeing that you have had some dissolved but still not happy with the placement you may want to try another injector. Otherwise, if you wanted to try another treatment entirely, Accutite for the eye area would be a great solution for you. AccuTite Skin tightening treatment is the smallest, minimally invasive device on the market. However, filler usually does take care of the hollowness under the eye and a great option as well. For the creasing while smiling you could try the morpheus treatment which stimulates collagen and elasticity giving you an allover tighter look which may help the creasing cause when smiling. Good luck!

Fillers like Belotero, Volbella, and Restylane Silk are good for improving under the eyes, but keep in mind that a combination approach will give the most improvement. My patients try to get non-surgical treatments to avoid surgery, so we use fillers, lasers, microneedling/PRP and stem cells. I suggest consulting with an expert to develop a treatment plan best suited for you. Best, Dr. Emer​​​​

Typically fillers do well in this area. The key is selecting an experienced injector who in turn will select the appropriate product and inject it appropriately. For fine lines and wrinkles you can consider lasers, chemical peels or microneedling. These can improve overall skin tone and texture. We also recommend using medical grade skin care products and wearing sunscreen every day.

This is a very common problem and question! Filler under the eyes in all about placement. It should be placed deep, along the orbital rim bone, and not in the muscle - filler placement (and even fat placement) in the muscle is a very common mistake with serious complications. Filler placed in the muscle will result in accentuation of the muscle and abnormal movement during animation. Filler placed too superficially can be seen as a blue hue, and often requires dissolution. Under eye filler placement also usually requires a combo approach with cheek filler, as part of the problem with volume loss around the eyes is a result of cheek deflation and descent. I would recommend visiting an oculoplastic surgeon for under eye filler placement, as these physicians receive dedicated training on the eye and periorbital zones. They are well familiarized with the anatomy and layers of tissue around the eyes, including exercising the highest safety standards for vision.

HI there,
Everyone is not a good candidate for dermal fillers and patients need to be chosen carefully. For instance patients with bags under the eyes with skin laxity, are not good candidates. Other things to consider would be the thickness of the skin, hyperactive muscles around the eyes, and skin texture. If fillers are not placed deeply they can migrate and interfere when the patient smiles and moves the muscles of facial expression. It would be helpful to see your baseline pictures to see if you were a good candidate in the first place. The nice thing about dermal fellas is that they can be dissolved.

Dear hellothar22, Thank you for sharing the photo. These are good quality photos but nothing replaces an in-person consultation for accurate examination and treatment planning. What you report as a "genetic problem" is possibly from how your face moves and produces creases due to the movement. This repetitive movement with time and change in skin texture can lead to more permanent fine lines, and that is likely why you are noticing it more as you age. Although little can be done to change how you emote naturally, to reduce fine lines around the eyes, generally we recommend skin resurfacing type of techniques, such as gentle lasers like pearl/genesis, clear + brilliant, or chemical peel, or microneedling / microchanneling treatments, and in combination with botox to reduce some movement around the eyes. For some patient, additional tightening type of treatment may be beneficial, like radio-frequency (RF) microneedling or thermage(which is also a radiofrequncy treatment) for eyes. Additionally, a good eye skin routine is very important to treat the delicate area. Hope this helps.

In my personal opinion no hyaluronic acid fillers should be used in the eyelid area unless the individual has very thick skin. Almost invariably hyaluronic acid fillers result in bubble formation as well as Tyndall effect. In my opinion fat grafting, when properly performed, produces permanent and natural results. I hope this helps and good luck from New York City plastic surgery