What can be done about my lower eyelid wrinkles and dark circles? 40 y/o (photos)

The wrinkles can be treated with Botox and the dark circles can be treated with bleaching agents. I recommend you see a dermatologist.

Best Wishes,

Gary Horndeski, M.D.

Based on the photos, it seems that a combination of lower blepharoplasty and periorbital fat grafting would be a good solution in your case; possibly a mild chemical peel of the eyelids. All of these should be done as a single procedure. In-person or teleconference consultation with a board certified plastic surgeon with experience in periorbital rejuvenation is recommended. Good luck.

Your still young and the problems do not appear particularly severe. So, before jumping into expensive, aggressive surgeries and long posttreatment downtimes, you might consider more simple solutions following the rule that the simplest approaches are often the best solutions. A series of in-office, professionally performed superficial peels using either full concentrations of glycolic or salicylic acid, Jessner's Solution or low concentrations of TCA accompanied by the at-home, daily use of topicals, such as retinoids and/or glycolic acid would be a good way to start, especially at your relatively young age and relatively non-severe crinkling and dark circles. You would be wise to make sure to consult with a board certified cosmetic dermatologist. Also be wary of claims for expensive fraxel laser, RF treatments, etc. as to date the value of these "bells and whistles" are supported more by marketing hype and social media buzz and little hard science. Hope this helps and best of luck.

To reduce under-eye wrinkles and dark circles, you can consider several treatments:
- Fillers (e.g., hyaluronic acid) to restore volume and smooth wrinkles.- Laser resurfacing (CO2 or Erbium) to improve skin texture and stimulate collagen.- Microneedling with RF to tighten the skin and smooth fine lines.- Botox for dynamic wrinkles like crow’s feet.- IPL or Fraxel to address pigmentation and dark circles.
A combination of these treatments often provides the best results. Consult with a plastic surgeon to create a personalized plan.

Dear Stagnerj,
Lower eyelid rejuvenation may include many options depending on the issues of concern. Your issues involve dark circles and skin wrinkling. Dark circles can be a complex issue in and of themselves and may involve the use of bleaching creams, retin A, sun screen. Laser treatment of dark circles is a double edged sword, and may in fact worsen the condition. A gentle amount of botox to the lower lid may improve the wrinkling that you are experiencing with squinting, and is usually coupled with crows feet treatment as well. An in person evaluation would be needed to fully assess your concerns and options. Good luck!

The best way to minimize wrinkles of the lower eyelids is to wear daily sunscreen and avoid excessive sun exposure.
Once wrinkles form it fix the problem.
Prevention is far better than treating the problem.
If the problem already exists the treatment options include Botox, laser, resurfacing, chemical peels, volume restoration and in some instances lower eyelid blepharoplasty surgery. Personally, I’m not a big fan of removing skin from the lower eyelid.
Wrinkles of the lower eyelid are notoriously difficult to treat, and often on the partial improvements should be expectedBest,
Mats Hagstrom MD