What procedure to use for stubborn genetic lines under eyes (Photo)?

Thread lifts would not help and are not appropriate for this region. (Frankly, they are really not even that good or long lasting for most things for which they have been hyped). No surprise that microneedling pen did not work, since microneedling is best reserved for treating superficial surface skin texture and color issues. Microdroplets of Botox placed in appropriate locations in the lower eyelid can help to diminish any muscular contribution to the formation of these lines, and can be especially helpful if the lines become more pronounced with smiling (i.e. with motion). It's difficult to say from the one photo, but a bolus of a lifting filler, such as Restylane Lyft placed in the cheekbone regions may help to stretch and straighten the under eye skin. And finally, a series of superficial peels, such as with low strength TCA, can help to tighten the skin, as well. Make sure that you consult with a board certified aesthetic physician. So, no need to despair. Best of luck.

We have seen improval of deep lines of the face and periorbital area with application of nano-fat grafts. Consultation with a plastic surgeon familiar with this technique, which is still in phases of clinical and scientific evaluation, is recommended. good luck.

My preferred treatment for fine periorbital lines is micro botox.Small amounts of neurotoxin gently relax the orbicularis oculus muscle to help soften these little lines.Dermal fillers can soften, however they can also "pool" and fluctuate with high salt intake, MSG, alcohol etc and I see many clients requesting to have them dissolved with hyaluronidase enzyme (even up to 5 years after the initial treatment). On MRI scans dermal fillers can last several years in the orbital cavity.