Dynamic Wrinkles Under Eyes, What's the Best Option? Eyelid Surgery, Laser, Chemical Peel? (photo)

Dear All Dr, The wrinkles under my eyes and the crow’s feet bother me immensely. Please look at my photos and tell me what correction method you would suggest. In the past I tried, restylane, retinol and topical vitamin c without any results. Botox had good impact on the crow’s feet but made the wrinkles under my eyes worse

Doctor Answers 7

Combo of Botox, fillers and lasers best for correcting wrinkles around eyes

Wrinkles are the result of the loss of fat, collagen and elastin fibers as well as the dynamic movement from caused by smiling.  We can improve the appearance of the wrinkles and lines caused by the movement with Botox, fillers and lasers; specifically the C02 laser which is used to tighten the skin.  The combination of these three procedure will drastically help the overall appearance but will not completely eliminate the wrinkles.


Palm Springs Dermatologic Surgeon
5.0 out of 5 stars 4 reviews

Botox and laser

I think you would be happiest with botox and a laser treatment. Laser will improve the skin of your whole face and fine lines while dynamic lines will be improved with botox (or dysport).

Jacob Freiman, MD, FACS
Miami Plastic Surgeon
4.5 out of 5 stars 268 reviews

Treatment of dynamic periorbital wrinkles

You may need a combination of botox, fillers and laser to achieve the best results. Some of your lines are dynamic and respond to botox. Others are more static and would need the laser to maximize the improvement. Also, you have some shadowing and depth which might be best addressed with fillers. I hope this information helps.

Scott Trimas, MD
Jacksonville Facial Plastic Surgeon
5.0 out of 5 stars 20 reviews

Botox best first choice for dynamic wrinkles

Botox is your best first option for the treatment of dynamic wrinkles.  The results are temporary, but Botox will relax the muscles that are causing all the lines to form around your eyes when you smile.  Botox will not cause the lines to disappear, but you should see significant softening of the lines.  More permanent options for collagen restoration can also be explored depending on your candidacy for treatment - such as laser resurfacing or fat grafting to the face.  From your photos, its unlikely that topical treatments will make much of a difference.    

Sam Naficy, MD, FACS
Seattle Facial Plastic Surgeon
4.7 out of 5 stars 221 reviews


The crowfeet area can be treated nicely with Botox.  Fine wrinkles of the lower eyelid can be treated in several ways Chemical Peel, Laser resurfacing or surgery.

Todd B. Koch, MD
Buffalo Plastic Surgeon
4.7 out of 5 stars 35 reviews

correcting wrinkles around eyes

Correcting the wrinkling around the eyes is not a simple , one procedure, solution. I think that my approach would be laser and  botox/dysport. You might even benefit from fillers to add volume to sides of face(and maybe eye areas as well) which would change the way the skin drapes. I am curious to hear the opinions of the plastic surgeons as they might have a different approach.

Jo Herzog, MD
Birmingham Dermatologist
5.0 out of 5 stars 18 reviews

Best treatment for eye wrinkles

The best treatment for wrinkles like the ones pictured is Botox or Dysport. Even though use of these products in this area is not an approved indication, it works well because the muscle that causes these wrinkles is right under the skin and easily accesible. One caveat: dont get treated too far down the cheek because it will affect the muscle that create smiles.

Lasers will smoothen this area but wont last until something relaxes the muscles that are causing the wrinkles.

Kenneth Beer, MD
Palm Beach Dermatologic Surgeon
5.0 out of 5 stars 8 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.