What can I do about dynamic wrinkles under the eyes? Filler, laser?
Doctor Answers 4
There are a few options that I can suggest to improve your condition. A retinol based eye cream is great option as a start. Options include:
-ZO® Olluminate Eye Repair
-SkinCeuticals® AOX Eye Gel
Other options include botox injection into the lower eyelid. Dermal filler injections might be a great option as well. Surgery for excessive buldging might be an option as well. Skin resurfacing procedures (laser resurfacing with CO2 laser, Er:YAG laser, Fraxel DUAL®, PicoSure® FOCUS Lens Array or OBAGI® controlled depth chemical peel) might be an option. This is an advanced technique so be sure to get an experienced dermatologist or plastic surgeon consultation for recommendations and treatment options.
Dark Circles, Eyelid Wrinkles/Bags Treatment -- Restylane or Belotero with Cannulas, Clear+Brilliant, Eclipse Micropen, Viva
All my patients are on topical lightening agents, typically a vitamin C serum product in the AM and a brightening agent and/or a vitamin A based product in the PM. Sun protection is essential.
Resurfacing and tightening are essential. My patients get offered a menu of options, for which a combination gives the best results. Light salicylic acid peels help give textural and pigment improvement; nonablative lasers (Fraxel or Clear + Brilliant) can be used to tighten and improve fine lines/wrinkles and crepe skin; fractional radiofrequency devices (Sublative, Viva) are cutting edge and improve texture, tone, and wrinkles with very little downtime; radiofrequency with pulsed electromagnetic fields (Venus) are amazing for puffiness and bags, in patients who do not want eyelid surgery; appropriately placed fillers can replace lost volume, cover up the vessels and fat pads below improving the appearance -- patients should pick a well experienced practitioner to prevent complications such as Tyndall (blue discoloration) and irregularities, one that uses a cannula for injection will help give results with little bruising or swelling; microsecond Nd:YAG laser treatments (Laser genesis) has produced dramatic improvement in discoloration in some of my patients and is safe in dark skin types, similar to the radiofrequency devices. For lifting, ablative laser resurfacing such as co2 laser combined with monopoloar radiofrequency deep heating (thermage) give amazing results. The key is for a patient to see a cosmetic dermatologist with experience in all the latest devices and techniques so the persons goals can be met by a combination approach of individualized treatments and skin care. In some cases, those who smile and have crepe skin or under eye wrinkles, a small amount of neurotoxin (botox, dysport, xeomin) strategically placed in the lower eyelid skin can improve wrinkles dramatically and give the eye a more "open" appearance.
Laser then filler.
You can expect good results with that combination of lasers and fillers- you are absolutely correct.
Dr Davin Lim
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Strategy for Dynamic Wrinkles
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