Which procedure should I be asking about in order to get rid of the lines under my eyes? (Photo)

I have recently had Botox around my crows feet and Restylane in my tear troughs and fat pads. While there has been improvement in how my under eyes look, I am still not 100% happy. I am still bothered by the large half circle lines under my eyes. I was told there was nothing else to be done for them. Wondering if lower eyelid surgery would help to correct this problem or if there is some other procedure I should be asking about or if this is the best it's going to get?

Doctor Answers 5

Several options for your lower lids/tear troughs

Thank you for your question.  There are several options for treating the puffiness under your eyes.  Sometimes adding more volume to your cheeks can make your lower eyelid puffiness look reduced.  I find most people undertreat their cheeks and will need more filler for volume.  Sometimes you need a combination to get the desired look.  Surgically removing fat from below your eye can reduce the puffiness, and a chemical peel, laser, thermismooth or possibly surgical excision of the skin can tighten the looseness of the lower eyelid skin as well.  It is hard to tell you without seeing you.  Hope this helps.


San Francisco Physician
5.0 out of 5 stars 1 review

Tear troughs

Hello, and thanks for your question and photo. I'm sorry you did not get the result you had hoped for. I think the reason you are not seeing optimal results is that the volume loss in your cheeks has not yet been fully corrected. I usually start with this area when treating tear troughs, as I find that much of the tear trough line is usually due to volume loss in the cheeks. Voluma is a great product to use in this area. In order to determine the best treatment plan for you, I recommend an in-person consultation with an expert. Best of luck, Dr. Frucht.    

Corey Frucht, MD, PhD
Santa Barbara Dermatologic Surgeon
5.0 out of 5 stars 4 reviews

Corrective treatments for under the eyes

While it is difficulty to make a full assessment without seeing your before pictures, just taking your picture at current face value (pun intended!) I would say you are not finished restoring volume to the tear trough and mid face. In addition there are surgical procedures that can correct the lower lid fat pad like lower lid blepharoplasty. You would likely benefit from more well placed filler in those areas with topical treatments such as chemical peels and laser to address the fine wrinkles and even skin tone. Our practice uses a multi-modal approach to create a synergistic effect over about one years time without any surgery. This allows us to achieve a natural result with minimal downtime. It is important to understand that once your desired result is achieved you will need maintenance treatments as unfortunately to date we have not learned to how to halt the aging process completely. I suggest you find a local doctor with the appropriate skill set to meet your needs as there is no one size fits all when it comes to facial cosmetics. Hope this helps! Good luck and don't forget to wear your sunscreen.

Lower lid lines

Thanks for your question and photos. The Botox and tear trough filler is definitely a good start. If you want to make it a little better, you may have to consider lower blepharoplasty to remove some of the extra skin and some of the fat in a very conservative manner. I would also use fat grafting to fill out the mid face to provide support under your eyes and make the line better. Remember, all these will make improvements but goal is not necessarily to achieve '100%' correction of the lines, fat, skin in order to keep it looking natural and avoiding complications. Good luck.

Jeffrey Jumaily, MD
Toronto Facial Plastic Surgeon
5.0 out of 5 stars 5 reviews

Tear through

Thanks for your question. You can also try combination of PRP laser and RF. If no response then the only option would be surgery.

Reza Akef, MD
Toronto Physician
5.0 out of 5 stars 1 review

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.