What is the best treatment for the wrinkles under my eyes and the loose crepey skin on my neck? (Photo)

Wrinkles under the eyes can be treated with a variety of options. In some cases, the only solution is surgical intervention such as a lower eyelid lift. Laser skin resurfacing could help, but this depends on the patient. For laxity of the neck skin, there are MANY "non-invasive" options out there, but most patients end up spending a ton of money and wasting their time with these devices. In many cases, a neck lift is indicated to tighten the neck skin, and 44 is definitely not too young for this type of procedure. In some cases, a mini lift is all that is needed. Laser resurfacing on the neck can offer some degree of tightening, but this usually offers only very mild results in the neck.
Be sure to see an expert like a facial plastic surgeon to review all of the surgical and non-surgical options in detail.
All the best,

Fractional CO2 laser is an excellent tool for skin rejuvenation in our center in Santa Monica. We use the fractional multi-depth ablative approach to help resurface the skin, recontour acne scars, improve incisional plastic surgery scars, and reduce surface irregularities from skin tone to dark pigmentation. Our approach utilizes a multi-depth approach that targets melanocytes in the epidermis and collagen fibroblasts in the dermis. This approach can be combined with a TCA Peel in a process known as a sapphire peel. Fractional laser is excellent for acne scars and contour scars in the skin. Patients are advised to undergo skin protocols with Melarase creams before and after treatment to help reduce pigmentation. Melarase AM, Melarase PM, and Melapads can seriously improve surface sun damage and UV related pigmentation. After the laser, we expect redness for a few weeks as the skin improves. PRP and Hydrafacial enzyme facials can further improve skin quality after fractional co2.

Best,
Dr. Karamanoukian
Realself100 Surgeon

I tend to start with less invasive options for someone in your age category.  There is no single best treatment, but you can see benefit with a combination of injectibles (Botox or similar for neck bands and lateral lower lid wrinkles) and topical treatment such as radiofrequency for both the neck and periocular regions.  These should help and hopefully keep the surgical options farther out for you, as you are still early for those.  

Some people require surgery to get the best improvement.  Non invasive options for improvement to the neck include:
botox, dysport or xeomin and/or fillers to help platysmal bandsthermage radiofrequencyultherapy high intensity ultrasoundPDO nova threads or instalift for liftingsculptra injections for collagen productionbtl exilis ultra, venus legacy, and thermi250 for constant collagen stimulationJ plasma or thermiRF internal tighteningI recommend a combination of fillers, lasers and microneedling/prp to improve under the eyes. I recommend getting a formal evaluation with an expert. Best, Dr. Emer

Thanks for your questions and posting pictures.  Your issues mirror the same symptoms we discuss with our patients every day.  There are 2 easy answers anyone can do on their own.  First, wear a quality sun screen every day!  Next, keep up with your annual eye check ups.  You would be surprised how many eye area wrinkles we have seen corrected with a new eye glass prescription.After a consultation in a medical setting, you would probably be offered several treatment options from a topical eye cream, properly placed Botox, chemical peels, RF skin tightening or even lasers.  It really depends on your time frame to correct, your ability to take down time and budget.  Best of luck.