40, losing elasticity around the eyes. What procedure do I need? (Photos)

At least from the one smiling photo provided, there appears to be a smile-related wrinkle to the sides of the eye. If this is so, this would likely be a crow's feet wrinkle for which Botox would be the appropriate, non-invasive means for treating it and preventing the situation from worsening. If the crease remains when the face is at rest (a static wrinkle), I.e. not smiling, then the use of a low viscosity, malleable, cohesive HA filler could be used additionally to elevate and smooth the crease. You would be wise to consult with an experienced, board certified cosmetic dermatologist injection expert. Best of luck.

As we enter our 40s, skin elasticity decreases and sagging tends to progress more rapidly. From your photos, it appears that you're particularly concerned about the skin on the outer corners of your eyes.The creasing in the outer eye area when smiling also seems to be a concern. One simple option to consider is Botox. Botox works by reducing muscle movement, which helps prevent and soften wrinkles around the outer corners of the eyes.However, if there is actual sagging of the eyelid skin, a more effective solution may be a surgical approach involving an incision just below the eyebrow. This allows the skin to be lifted and tightened, improving the drooping or hooded appearance.Sub-brow lifting is a surgical procedure that removes excess skin beneath the eyebrows to correct upper eyelid sagging and improve overall eye appearance.

You will need an extended brow lift. The brow lift will pull up the eyebrows, pull up the upper eyelids, and pull the lateral corners to take care of the lateral wrinkling.

Best Wishes,

Gary Horndeski, M.D.