Crows Feet Under Eyes - What is the most effective treatment for puffy eyes. Too much loose skin. Horrible lines. (photo)

I have tendency for water to accumulate under my eyes and swell and form bags. I tried botox and fillers couple of times and the area directly under my eyes had swollen up and I stayed with bags under my eyes for couple of months. One doctor told me its because water is not drained. What other treatment options can help me ? Maybe there is something wrong with the technique that was used to do Botox ? I am desperate for some treatment ideas. Thanks.

Doctor Answers 9

Crow's feet under eyes, what is the most effective treatment?

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Thank you for sharing your question. I recommend Botox to soften the crow’s feet and prevent these lines from worsening in the future. In order to improve the appearance of the lose skin you are noticing around the eyes, I recommend a total resurfacing laser. In my practice, my patients have had excellent results with a tunable resurfacing laser to improve the appearance of fine lines, sagging and overall texture and tone. You may also be a good candidate for a blepharoplasty, however it is difficult to properly assess based on this photo alone. I recommend scheduling and in-person consultation with a board-certified specialist who is experienced with inject tables, lasers and eyelid surgery. 

Los Angeles Facial Plastic Surgeon
5.0 out of 5 stars 73 reviews

Dark Circles, Eyelid Wrinkles/Bags Treatment -- Laser Resurfacing, Clear+Brilliant, Micropen, Viva, Ultherapy/Thermage

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Fractional lasers to resurface the under-eye skin will help with the wrinkling. It doesn't sound like you have crow's feet, as they are at the corners of your eyes, not underneath them. You would probably also benefit from microneedling/PRP and fillers. Please talk to an expert for  treatment options.  Best, Dr. Emer.

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.8 out of 5 stars 207 reviews

Eyelid Surgery

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Thank you for your question. There are many options, but the most effective solution would most likely be a combination of eyelid surgery and laser skin resurfacing/chemical peel. I suggest that you consult with a single or board certified facial plastic surgeon.Best wishes,

Ross A. Clevens, MD
Melbourne Facial Plastic Surgeon
4.7 out of 5 stars 124 reviews

Eyelid Bags

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Looking at your photos I would suggest a combination of a lower eyelid blepharopalsty with botox and laser skin resurfacing.  This combination would rejuvinate the lower eyelid and crows feet area without the swelling and sagging that you have experienced before.

Jessica Lattman, MD
New York Oculoplastic Surgeon
4.7 out of 5 stars 28 reviews

Crows Feet Under Eyes - What is the most effective treatment = eyelid surgery #crowsfeet #eyelidsurgery

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"Crow's feet" under the eye are secondary to excess of slower lid skin, rather than construction of the muscle underneath (cause of the lateral crow's feet that is treated with Botox)Excess of lower lid skin when is minimal, could be improved with chemical peel or lasers. However, when the excess of skin is significant ( eg, patients in the late 40s and older), surgery (lower lid surgery or blepharoplasty) is the only way to remove that excess of skin.  

John Mesa, MD
New York Plastic Surgeon
4.9 out of 5 stars 141 reviews


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Surgically removing some skin or tightening with lasers/chemical peels are the options you need to consider.  Will likely take a combo treatment plus long term Retin a/vitamin C creams to thicken the skin.

Under eyes

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Thank you for your pictures! Botox and fillers can help, however, they will not smooth out the excess skin that you see when you are smiling and wrinkling your eyes.  In order to fully relax this muscle, you may end up creating hollowness as the muscle relaxes and bags under your eyes can actually look worse.  An ablative resurfacing procedure with a fractionated CO2 or an Er:YAG laser would help tighten those fine lines and the skin, however, it will not get rid of the problem completely as you may still have some excess skin.  There is downtime with the ablative procedures, anywhere from 2-3 weeks before you are fully healed.  A lower eyelid blepharoplasty (sometimes all you need is a skin pinch, other times a little more) can be done at the same time as a fractionated CO2 to really polish things off nicely for you.  This is all dependent on skin laxity, your lid laxity, whether or not you have bags under your eyes, the position of your cheek bone, etc etc etc.  Long story short, there are a multitude of options available for you which can best be discussed during your consultation.  I hope some of this information helps you and provides you some talking points during them.  A physical exam is the best way to determine what one may be a candidate for.  Best of luck!

Miguel Mascaro, MD
Delray Beach Facial Plastic Surgeon
5.0 out of 5 stars 20 reviews


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It seems like you may  be a good candidate for upper and or lower blepharoplasty. Blepharoplasty is a surgery to repair droopy eyelids. This may include removing excess skin, muscle and fat. I do suggest  seeing a Board Certified Plastic Surgeon to get a second opinion. Thank you for your question and have a great day!

Sam Speron, MD
Chicago Plastic Surgeon

Treatment for under eye fine lines and wrinkles

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From your picture, it seems that there is some laxity of the skin as well as fine lines and wrinkles under (and around your eyes). Fillers and Botox are great options, but they may not resolve the issue completely. In your case, I would recommend 1 of 2 procedures. The first is some type of ablative laser treatment to your under eye area. This treatment is great for the treatment of moderate to severe wrinkles and will also tighten the skin. Under eye skin resurfacing is a great option, however it does require some downtime, as the area takes about 1-2 weeks to heal. The other option is a lower eyelid blepharoplasty with excision of skin and possibly fat (although in your picture, the real issue seems to excess skin). Some surgeons will also do lower eyelid resurfacing with an ablative laser at the same time as the lower eyelid blepharoplasty. Since a lower eyelid blepharoplasty is surgery, there is some downtime. On average, patients require about 2-4 weeks to heal from the procedure.

Maryam Nazemzadeh, MD
McLean Oculoplastic Surgeon
5.0 out of 5 stars 3 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.