Crepey under eye and hollows. I'm too young for birth, what do I do? (photos)

Question

I have big cheeks, high cheekbones. But, I have really crepey skin that ages me under my eyes and on my cheeks. I've considered these options, but not sure if there is a better one. Please advise! - under eye filler, but I'm worries it'll look weird with my big cheeks! - botox, but can botox work on the cheeks? - bleth (this is a last resort for sure!) My eyes were always one of my favorite features, but now they age me so much!

Adam Scheiner, MD · Answer

Dear Crystal,It appears you have aged skin due to previous sun exposure to the sensitive skin below and around the eyes. They can make a person appear old and tired even when they feel fine inside. First its important to protect your skin daily with good quality sun block and sun glasses. Next to reverse sun damage, certain creams containing Retin-A can help to a slight degree. More aggressive use of lasers can cause a more dramatic improvement in the skin quality in this area. I hope this was helpful.

Jason Emer, MD · Answer

A combination approach will give the most improvement. Fillers, lasers, and microneedling/PRP can improve under the eyes. My patients try to get non surgical treatments to avoid surgery. We use PRP and stem cells there often. I suggest consulting with an expert to develop a treatment plan best suited for your short and long term goals.For facial skin tightening, I recommend J Plasma, lasers (Fraxel, Clear + Brilliant, Co2), microneedling/prp, ultherapy and RF treatments to get the best outcomes. I recommend getting a formal evaluation with a cosmetic dermatologist. Best, Dr. Emer

Alexander Rivkin, MD · Answer

Hello and thank you for your question. I think that you should take the option of blepharoplasty off of the table. From your pictures, I think that your issue is twofold. There are hollows under your lower eyelids and you have crow’s feet. Crow’s feet can be improved with Botox, while under eye holllows can easily be improved with dermal fillers. The depression is caused by decreased fat in the under eye area, which is also creating a darker look because a shadow is falling into the hollow. Injecting fillers can mimic the volume that is missing there and will give you a nice natural look. This will also smooth out the transition between under eye and cheek, softening that "line" that is created between the two areas. You would need no more than 1 ml of filler, but you have to make sure to go to someone extremely experienced in the procedure for the best possible results. I specialize in these kinds of procedures, so I prepare Juvederm - a hyaluronic acid filler specifically for the under eye area. By using this preparation, I have been able to get the results to last for years. I routinely promise 2 years, but I have seen patients 6 years later where the filler is still there and looking great. The other advantage to a hyaluronic acid filler is that it is entirely reversible with a simple injection of enzyme at any time.
Otherwise, I agree with Dr. Scheiner's tips on taking care of the skin and lasers to build collagen and improve skin quality. Best of luck.

Camille Cash, MD · Answer

I think you are on the right track with treatments.  Botox will help improve the crow's feet area.  Fillers can help add volume and disguise under eye contour irregularities.  Lasers, chemical peels, and/or microneedling can be used to improve skin tone and texture.  I recommend using medical grade skin care products and protecting your skin with sunscreen every day.  Be sure to see an expert injector for a consultation.

Jonathan Kulbersh, MD · Answer

Under eye bags can be permanently corrected with surgery or temporarily camouflaged with fillers (Restylane, Belotero, Volbella).There are great non-surgical options to fill in under eye depressions and hollowness. Using dermal fillers, a liquid eye-lift can be performed. A dermal filler such as Restylane would be placed in the cheek and tear trough to hide the depression or bag underneath your eye.
Surgery would require a fat-repositioning lower lid blepharoplasty. In this surgical procedure, fat from the eye area is moved into the tear trough depression filling the actual depression. 
I hope this helps!

Crepey under eye and hollows. I'm too young for birth, what do I do? (photos)

Answers (5)

Answer: Eye treatment

Answer: Eye treatment

Answer: Crepey under eyes and hollows? Fillers or surgery

Answer: Crepey under eyes and hollows? Fillers or surgery

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Crepey under eye and hollows. I'm too young for birth, what do I do? (photos)

Answers (5)

Answer: Eye treatment

Answer: Eye treatment

Answer: Crepey under eyes and hollows? Fillers or surgery

Answer: Crepey under eyes and hollows? Fillers or surgery

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Recommended reading

Everything you need to know about Eyelid Surgery

Our mission is to create a world where every investment in modern beauty is Worth It.