What is best for under eye wrinkles: Botox or Fillers? (Photo)

Hi GG.  In many cases we will recommend a dermal filler under the eye to help with wrinkles, but for the dynamic kind you have, we would likely recommend a laser resurfacing procedure.  No treatment is going to be perfect, but we wouldn't use Botox as the amount of product required to help would be extremely small, which would mean that it wears off very quickly.  In addition, the possibility for making the under eye area sag because of the Botox would be high.  Botox is not commonly used in this way.  In person, we would be able to see you smile and discuss the benefits of filler vs. resurfacing.  For an example of Orange County eye rejuvenation using Restylane and laser resurfacing, check the link below.

Undereye wrinkles need to be treated with a combination approach of skin care, botox, lasers and/or radiofrequency. You can get amazing results, but you should see a cosmetic dermatologist with experience in treating this area which is sensitive and requires a meticulous provider to limit any complications.

For eye wrinkels in the crow's feet area, Botox works well. For under the eye wrinkles, CO2 laser resurfacing works amazingly well. For the volume loss, I would consider a filler. 

Hi GG. You do have some volume loss in your tear trough areas underneath your eye. You would benefit from a superficial filler such as Belotero to naturally fill these. As for the creases directly under your eye, in someone your age what I would recommend is a series of chemical peels that may help improve their appearance. There are also at home prescription strength creams that you can use, but they are more for maintenence and prevention than actual treatment. Laser resurfacing would be a more aggressive treatment. I would stay away from Botox and fillers in those areas. Hope this helps.

Botox works best for what you have described. Fillers in this area at your age have to be done very cautiously and will not correct a wrinkle problem.C a very experienced injector for this and do not shop price but rather quality.   

Thanks for your
question and photo. For the hollow under your eye, a filler such as Restylane
or Belotero are the most common HA fillers used here. Some also will use
Juvéderm in this area. For the skin itself, we would recommend starting with
skin care with eye creams such as Neocutis Lumiere. If needed, a fractional
laser skin resurfacing or sublative RF fractional treatment can be done which
will even enhance the results. Please consult with a board-certified
dermatologist or plastic surgeon to learn the best optimal results for you.

I cannot say for sure from the picture, but it looks like you do have a mild tear trough deformity.  This can be corrected with hyaluronic acid fillers such as Belotero or Restylane.  Botox would work for the dynamic wrinkles on the sides of the eyes and may diffuse to help with your area of concern.  So I would start with Botox in this situation and then move on to filler if the area still has wrinkles.  You should also see your dermatologist in person to look at the texture of the skin because if the issue is loose or crepey skin, then a resurfacing laser would be a good option.

For the appropriate patient, dermal fillers such as restylane or belotero, or laser work best to address wrinkles under the eye. Consult 3 experienced and expert board certified plastic surgeons to understand your options.

Treating wrinkles under the eyes is a complex question.  If you are treating the sun damage and texture under and around the eyes then eMatrix or Fraxel are the best lasers for this purpose.  Botox will only treat the crow's feet which are dynamic wrinkles around the eyes.  If there is a depression under the eyes I inject Belotero or Restylane under the eyes to correct the problem.  Please consult a board certified dermatologist with a great deal of experience in this area for the best cosmetic results. 

Thanks for writing,Botox is helpful with the crow's feet area but nowhere else under the eye. Fillers help the tear trough, but you don't have one. Lower lid wrinkles can be and usually are dynamic wrinkles, caused  by smiling i.e. compressing the mid-face.To go from simple to complex: topical creams ( not over the counter) can help to a degree, there are some good physician level products.Fillers may have a little effect, not much, laser resurfacing ( be very careful who you choose). These are some of your options, find a Board Certified Plastic surgeon who will take the time to examine you and review your options, think about it and choose carefully.Good LuckStephen M. Davis, MD FACSGreen Hills Plastic Surgery