Fillers or Botox? (photo)

I have the worst wrinkles under my eyes and very pronounced when I smile...which makes me not want to smile ever! I have had fraxel done once 4 months ago under my eyes. I have finally saved enough money to have either botox or some kind of filler. I need an eye lift I know which I doubt I will ever afford. My question is which one will work best for me? or should I do something different. My mouth is very turned down as well, but my eyes upset me the most. I am 39 and live in Denver

Doctor Answers 25

Fillers or Botox

Thank you for submitting your question.  Botox will help with the Crows feet and the down turned lip.  Lower eyelid surgery will also help. Consult with a board certofied injector.  Best woshes.

Dallas Plastic Surgeon
5.0 out of 5 stars 104 reviews

Eye Rejuvenation

Botox can help with your crow's feet.  Using filler or Botox elsewhere would likely be a waste of your money.  From your pictures, you have bags under your eyes - excess skin, fat and loose muscle.  Adding volume here with a filler will make this worse NOT better.

I suggest you see a board certified plastic surgeon in your area.

Asif Pirani, MD, FRCS(C)
Toronto Plastic Surgeon
5.0 out of 5 stars 35 reviews

Botox or Fillers for eyes

A combination of Botox and Fillers can be used to address the areas of concern. Botox will help with the crow's feet to the side of your eyes, while fillers can help with the volume lost below the eyes. The excess skin on the lower lids can be addressed surgically with excision or with laser resurfacing procedures. 

Meg Cherry, MD
Birmingham Dermatologic Surgeon
5.0 out of 5 stars 6 reviews

Fillers or Botox

Two different questions as these are not used interchangeably- Basically fillers restore lost volume and Botox works to paralyze muscles responsbile for unsightly wrinkles. Often they are used in different areas of the face.

Steven Hacker, MD
West Palm Beach Dermatologic Surgeon
5.0 out of 5 stars 4 reviews

Under eye wrinkles are a complex problem

It seems from the photo that what you really need is to see a plastic surgeon to remove the extra skin under the eyes.  Botox will only address the lateral crows feet.  I think you would be wasting your money to try fillers or Botox in this area.  I would consult with a board certified dermatologist for a true assessment who is familiar with cosmetic and experienced with injectables.

Michele S. Green, MD
New York Dermatologist
5.0 out of 5 stars 75 reviews

Fillers or Botox?

It would be great if one thing could address all your concerns, but unfortunately factors that contribute to the aging face are a little more complex.  Botox over the lateral aspect of your eyes, would help with relax the crow’s feet that are contributing to the wrinkles you see around your eyes.  You can consider Ulthera, which is approved for a nonsurgical brow lift, in combination with a fractionated CO2 treatment, to help with both lifting the brow, and the crepiness of the skin above and below your eye, respectively.   Good luck!

Sabrina Fabi, MD
San Diego Dermatologic Surgeon
5.0 out of 5 stars 84 reviews

Improving the wrinkles under the eyes

The wrinkles as noted in your photograph would improve with a small amount of Botox and likely some filler like restylane in the tear trough. Surgery is certainly an option as well, as are chemical peels, ProFractional ablative laser resurfacing, and even topical therapies containing Vitamin C, retinol, etc.

Benjamin Barankin, MD, FRCPC
Toronto Dermatologic Surgeon
4.8 out of 5 stars 50 reviews

Lower Eyelid Aging

One point to remember when considering the potential outcome of either a surgical or non-surgical approach to your lower eyelids is that this is a dynamic area of the face that is subject to change based on animation. When  you smile your cheek moves upwards and compresses your eyelid into a shorter dimension resulting in a creased or wrinkled appearance. This distance lengthens when you are not smiling and therefore the lid appears smoother. This issue will remain to some degree regardless of the treatment you select for the eyelid.  I would recommend that you have a consultation with a plastic surgeon certified by the American Board of Plastic Surgery to advise you on the best options in your individual case.

Bryan G. Forley, MD
New York Plastic Surgeon
4.9 out of 5 stars 12 reviews

Options for aging concerns

From the look of your pictures, if you are looking for a non-surgical approach, it appears that you would be a good candidate for botox to the crowsfeet and Restylane for the tear troughs. If you are trying to decide between botox or fillers that depends on what area you are more concerned about. Botox is very effective in smoothing out crowsfeet, glabellar lines (lines between eyebrows), lines around the mouth and forehead lines. When injected under the eyes, Restylane helps improve dark circles and fill in wrinkles. This helps to create a more youthful appearance; however botox and fillers only offer a temporary solution. In the future, if you decide to move forward with surgery, I would recommend an upper and lower blepharoplasty.  It may better to save money over the years and invest in the more substantial improvement that surgery can allow.  I hope this helps.

Paul L. Leong, MD, FACS
Pittsburgh Facial Plastic Surgeon
4.9 out of 5 stars 46 reviews

Save your money

People will spend hundreds of dollars on procedures that are not the actual answer to their issue. You need to have an eye lid surgery to actually be satisfied with your results. You can try botox and fillers but you will see minimal result. Instead of wasting your money on that, save for a few years and get the actual solution to your problem. You will be much happier that way. 

Phillip Chang, MD
Leesburg Plastic Surgeon
4.5 out of 5 stars 9 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.