3 months after Botox in the crows feet - what can I do to minimize the appearance of wrinkles in the under eye area? (photos)

Thank you for your question and photos. You may benefit from a combination of lower blepharoplasty and laser resurfacing to rejuvenate the skin under your eyes. Lower blepharoplasty is ideal for removing excess skin, tightening the remaining skin, and repositioning fat to achieve a smooth transition from the lower eyelid and upper cheek. This surgery can be combined with laser resurfacing to treat fine lines and reduce their appearance.
I recommend scheduling an in-person consultation with an experienced, board-certified facial plastic surgeon or expert injector. They will be able to review your treatment history and evaluate your concerns to determine the best way to help you achieve your aesthetic goals.

Hello,

If you did not have bags before the Botox injection, it could be possible that you were over injected. When your muscles move they pump fluid out of the area. If we relax the muscles under the eye the muscle pump doesn’t work effectively. This can cause fluid retention or Periorbital edema, which is self limiting. Using hot compresses can help Venous return and aid in minimizing the edema.

The eye area needs significant combinations to get improvement. Lasers like erbium, co2, halo, profractional/contour, or Fraxel can all be used to build collagen long term. Plasma pen is a newer less invasive option but will take many treatments and require proper skincare. Plasma Pen is focused electrical plasma energy to tighten skin, producing small columns of energy just above the skin, allowing the skin to tighten to help improve wrinkles. This area will have 3-5 days of small “dots” that will then scab and peel, then the skin will tighter and brighter after. Numerous treatments are needed over lasers where only one or two give a bigger result, but more downtime. After plasma pen you NEED peels 2 weeks like later Cosmelan, enlighten or aerify, see emeragecosmetics (link). At home derma rolling should be started weekly even after plasma pen or lasers to further increase collagen, see emeragecosmetics AERIFY x anteagemd stem cell ampules. To properly heal you need light Stim red LED, EmerageSkin refit face, refit eye; AnteageMD serum, silagen silicone gel, jan Marini bioshield, EmerageSkin enzymatic polish, and EmerageSkin hyla b and AOX, and Sente dermal repair. Otherwise there is EXTREME risk of pigmentation issues and “dots” in the treatment area. at home peels like cosmelan, enlighten and aerify along with dermarolling (AERIFY emerageskin roller with Anteage MD ampules) should be started now regardless for antiaging, sun damage, and wrinkle prevention. 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 such as eyelid blepharoplasty with or without fat pad repositioning (if doing lower eyelid surgery) will be the best long term. There are many things you can do to treat under eye hollows and dark circles without surgery. Non invasive less downtime options such as fillers, lasers, microneedling/PRP, cosmelan peels, and microneedling RF like Fractora, PiXel8 or morpheus can all help give some improvement. Accutite can often be used or stronger lasers like erbium or co2 spot treatment can tighten the skin and give very quick improvement in wrinkles and texture. I suggest you get a formal consultation to see what is best for you and your goals. Best, Dr. Emer.