45 - male, eyes look tired and age me - what are the best options? (Photos)

Question

Hello, I look relatively young and have almost no wrinkles, except for around my eyes. I feel like I look tired all the time and the wrinkles, especially when I smile in photos, are really bothering me. I am not sure what to do. I have done botox before, but not recently. It only helps mildly for the crow's feet. I am more bothered by the under eye area. What do you suggest?

Berlin Beauty Medical Aesthetics · Answer

Combining Botox, microneedling, and PRP (Platelet-Rich Plasma) injections can be an effective approach to address under-eye bags and crow's feet, which are common concerns related to aging and skin quality around the eyes. Here's how these treatments can work together:
Botox can be used to relax the muscles that cause crow's feet or fine lines at the corners of the eyes. This treatment helps reduce the appearance of these lines. Microneedling is a minimally invasive procedure that uses fine needles to create controlled micro-injuries in the skin. This process stimulates collagen and elastin production, which can improve skin texture and quality.Microneedling can help smooth the skin around the eyes and improve the overall appearance of fine lines, including crow's feet. Multiple sessions may be required to achieve the desired results. PRP involves drawing a small amount of the patient's blood, processing it to concentrate platelets and growth factors, and then injecting it into the under-eye area.PRP injections can stimulate collagen production, improve skin elasticity, and reduce the appearance of under-eye bags. This natural treatment can help rejuvenate the skin and reduce puffiness around the eyes.
It's important to note that the success of these treatments can vary based on individual factors, such as skin type, age, and the severity of concerns. 
Consult with a qualified medical professional experienced in these treatments. Hope that helps!...Lena

J. Renee Booth, MD · Answer

There are several treatments that help with fine rhytids/crepe-like texture to the skin. Topical treatment includes a daily tretinoin or retinol product in addition to regular use of sunscreen and moisturizer. This is generally helpful for maintaining skin quality even if you decide on other additional treatments. Radiofrequency microneedling treatments (such as Morpheus8) are another good option as mentioned previously. Fractionated lasers or full ablative lasers (erbium YAG) can achieve excellent durable results, however require careful post-treatment care with moisturizer and staying out of the sun. Appropriate after care is critical to recovery after laser treatment. Superficial fractionated laser (Moxi by Sciton) is a nice middle ground with great results and less intense after care. However, full ablation laser treatment can last 15-20 years, so it is the most durable of all the treatments. A skin pinch lower blepharoplasty can be done to remove excess skin. This has an easier recovery than full ablation laser and often has longer durability than fractionated laser. Last, but not least, Skinvive has been used under the eyes in Europe for years (as Volite). It is an injection used for hydrating the skin from the dermal side and is sometimes called a "skin booster". Juvederm reports a 75% patient satisfaction rate with use in the face and it lasts at least 6 months.

Camille Cash, MD · Answer

There are a few options for you to consider.  One is a combination of fillers, Botox, and Morpheus8.  The fillers can address volume.  The Botox will address dynamic wrinkles, and Morpheus8 can address skin tone and texture.  The other option is a lower blepharoplasty which surgically addresses the under eye contour.  See a board certified plastic surgeon near you to discuss your concerns and learn more about these options.

45 - male, eyes look tired and age me - what are the best options? (Photos)

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