I have these fine lines under my eyes just above cheek bone. (photo)

Can you please tell me if fillers or botox will help rid of these as I'm so down about them. They make my eyes look old and I'm very consious of them. Please help.

Doctor Answers 9

It depends on what's causing the lines.

Good question! Lines like these can have a number of causes, including sun damage. Based on your photo, I think you may get good results from laser resurfacing or even a strong chemical peel. Some filler or BOTOX treatments may also help, especially in tandem with resurfacing procedures. As always, be sure you're wearing plenty of sunscreen during the day to keep these lines from getting worse. See a board-certified dermatologist for a more thorough review of your options.

Houston Dermatologic Surgeon
3.7 out of 5 stars 6 reviews

Treatment for fine lines under eyes

There are several great treatments for the fine lines under the eyes. Some of them may be related to sun damage, muscle movements and general decrease in collagen and elastin.
I definitely recommend that you have thorough consultation with a doctor who specializes in non-surgical treatments as the treatments that you will likely need are non-surgical in nature.
I hope that helps and best regards, Dr. Sapijaszko.

Mariusz Sapijaszko, MD, FRCPC
Edmonton Dermatologic Surgeon
5.0 out of 5 stars 10 reviews

Best treatment for fine lines under eyes

The combination of Botox, fractional laser resurfacing, and a light filler such as Belotero (if needed) would get best results.  Multiple laser treatments may be needed.  Do Botox first to minimize movement during healing from the laser.

Lawrence Osman, MD
Los Angeles Dermatologic Surgeon
5.0 out of 5 stars 5 reviews

You will benefit from Nano Fat Fill / Chemical Peels

Dear Olivia, you may benefit from periodic chemical peels. Alternatively, you can try Nano Fat Fill. It can improve the quality of the underlying skin very well. 

Botox and Fillers will not help Facial Fine Lines. Use retinoids, exfolliation, peels, UV protection.

Dear olivia04:

Thanks for sharing your photo. Based on the limited information and picture, I agree with you. Fillers will simply expand the cheek without stimulating an adequate amount of collagen repair. Botox will not help static epidermal fine lines. Below you will read more of the options available. My best recommendation is to seek the advice of a Certified ZO Skin Health Team for proper rejuvenation and maintenance of your skin.

The process of aging is the passive inability for your body’s tissues to repair and regenerate themselves. The act of rejuvenation is to actively reverse and dynamically assist the repair of your tissues on a daily basis. When significant laxity exists, surgical skin and soft tissue redraping or lifting are required.

Facial Aging develops from the 5 different layers of the skin, fat, muscle and bone.
During the first 20 years or so of life, the body genetically determines how to mature and repair a constantly changing “face” including all these layers (as it does elsewhere in the body). Thereafter it remains robust in repairing itself from injury but the accumulation of environmental, health and nutritional exposure will add to the passive inability for the body to care for itself after 30. This is when physical changes such as skin laxity, irregular pigmentation, lines and wrinkles and skin diseases occur. We now have many options to rejuvenate the layer or layers of the face which need care or stimulation to reverse the aging trend.

1. The top layer or stratum corneum of the epidermis is the rough, pigmented layer of the skin; creating most of the depth of the wrinkle.

-Exfoliation is best for this using:
-Retin-A (ZO Obagi Skin Health System), which also renews and regulates improved function of the deeper epidermis,
-Some lasers and chemical peels.

2. The second layer is the dermis which thins with aging. The natural collagen, elastin and hyaluronic acid (which hydrate and toughen the skin) are thickened by the use of:

-fillers (Restylane and Juvederm), or
-Retinoids (ZO Obagi Skin Health System), which also renews and regulates improved function of the deeper dermal skin cells.
-Sculptra properly managed is the latest sensation to stimulate firming and thickening of the dermis
-Thermi RF is a non – surgical option. Use ThermiSMOOTH superficially or ThermiTIGHT to tighten THE skin using a micro-invasive technique.

3.The next layer or fat also thins or droops with age and maybe:
-filled (Restylane and Juvederm), fat grafting or
-redraped (threadlift, short-scar, traditional, endoscopic face / neck / brow lifts / cheek)
- LipoContouring of the face and neck with or without fat grafting may provide the balance and contour you seek without general anesthesia.

4. The muscle which creases the skin into wrinkles and folds is weakened and rebalanced with
-Botox or similar injectable muscle relaxers like Dysport or Xeomin.
Chemical peels and laser tightening are single, “static” attempts to “jump” the repair system into collagen formation. They should be performed every 3 months in order to achieve a more dynamic stimulation of the immune system.

Everyone needs one or more layered improvement and in personalized combinations to achieve their optimal result. 

All surgical, minimally invasive and non-invasive procedures and their combinations should be discussed following a proper examination with a well versed, Board Certified Plastic Surgeon who performs all of these options so you will not receive a biased approach because he limited in his skills.

I hope this is helpful. All the best!

Dean P. Kane, MD, FACS
Baltimore Plastic Surgeon
4.8 out of 5 stars 69 reviews

Treatment for Fine Lines

Regular use of a tretinoin in combination with microdermabrasion can help improve the appearance of fine lines. Microneedling, laser, or IPL treatments can also help. The most helpful advice, however, is to minimize your exposure to sun/UV rays, whether natural or artificial. UV rays harm the elasticity of your skin and contribute to sagging and wrinkles by breaking down collagen. SPF should be in your daily moisturizer and use a hat/shield as much as possible when you're outdoors.

Millicent Odunze-Geers, MD, MPH
Sacramento Physician
4.6 out of 5 stars 5 reviews

Fine lines under the eyes

Great question! I actually don't believe it is Botox or fillers that you need. Good skin care goes a long way with fine lines. Focus on proper sun protection, a topical antioxidant, and a retinol. In addition, a hyaluronic acid based serum will help plump the skin and soften the fine lines. I really like HA5, a new product by SkinMedica, when it comes to fine lines. Procedures that I find very useful for fine lines are microneedling, nonablative lasers like Fraxel, and superficial chemical peels. 

Botos and fine lines

Botox can improve the appearance. I don't like the term get rid of but Botox will make a big difference although  not permanent. Be sure you see an experienced board certified dermatologist or plastic surgeon as this area is not easy to treat

Melvin Elson, MD
Nashville Dermatologist
5.0 out of 5 stars 6 reviews

Under eye wrinkles

Thanks for your question. Your would do well with some form of collagen induction procedure such as Ultherapy smoothing treatment (1.5mm transducer- series of 3) or medical microneedling with platelet rich plasma/PRP- the so called Vampire facial- series of 3 (more like 6 if done without PRP). These types of procedures stimulate natural, new collagen formation which will last far longer than botox. Botox in this region runs the risk of causing a puffy appearance ("Festoon") especially if done by an inexperienced injector and the result will be short lived.
Lisa Vuich, MD

Lisa Vuich, MD
Nashua Physician
4.7 out of 5 stars 10 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.