What to do about undereye lines? (Photo)

Question

I have these lines, so called jelly rolls under my eyes that make me look tired and sleepy all the time. I've tried filler, prp, botox in the past, with no results. What else can I try to smoothe the transition between undereye and cheek without those hollows and small rolls being so obvious? I am petite, height/weight proportionate, exercise and eat healthy. Never alcohol, drugs, smoking, etc. though been a night owl many years + somewhat hereditary (ugh).

Jason Emer, MD · Answer

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.

Jonathan Kulbersh, MD · Answer

Thank you for your question. A liquid eye lift may be a good option for you. It combines dermal fillers and Botox to help with bags and hollowing under the eyes. Placement is key when contouring the face with injectables and makes a significant difference in results. Blepharoplasty may be another option for you. It is a surgical procedure that removes excess skin from the eyelids and can help remove bags and sagging that create the rolls. Working with a board-certified facial plastic surgeon can help provide you with more information and expert guidance for a personalized treatment plan.

Anthony Farole, DMD · Answer

Hello, my advice is there are two things to consider. First although you said you had Botox I don’t know exactly where the Botox was injected and it matters a lot where it was placed. There is an injection technique in the lower lid just underneath the lashes with very small doses of Botox that could diminish those so-called “jelly rolls”. 
If that does not provide satisfactory results two other alternatives I would suggest are one plasma IQ the other would be a lower lid blepharoplasty. Of course for the best advice an in person evaluation is necessary.

Akshay Sanan, MD, FACS · Answer

Dear janedominguez,
Thanks for your question. Jelly rolls in the under eye area can occur due to excess or overactive eye muscle called the orbicularis oculi. Botox is often used to weaken the muscle and thus limit the bunching of skin from muscle contracture. However, if Botox isn't giving you the result you're desiring, a lower blepharoplasty can improve this more. A lower blepharoplasty requires making an incision in the lower eyelid skin to remove extra skin, remove extra muscle and meticulous stitching to help smooth the transition from the undereye to cheek area. I recommend you consult with a board certified facial plastic surgeon.
All the best,Dr. Sanan, MDFacial Plastic SurgeonDouble Board CertifiedLos Angeles, CA

What to do about undereye lines? (Photo)

Answers (4)

Answer: Surgical option

Answer: Surgical option

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What to do about undereye lines? (Photo)

Answers (4)

Answer: Surgical option

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