Wrinkles in the Eye Contour- Fraxel? Ultherapy? Both? No fillers! (Photos)

Hey I am 32 and very thin. I have thinning skin in my eye contour, I took pictures smiling and relaxed. I do not want to do fillers. What are my options? I want this gone. Was thinking ultherapy followed by fraxel after. At different times but that regimen. Help!

Doctor Answers 7

Lasers, Peels, Microneedling and PRP + Botox

Ok, whilst fillers will be ideal, this is ruled out, so you have options including TCA peels, Co2 laser, oircroneedling with PRP and Botox. A combination treatment will be ideal. All the best, Dr Davin Lim. Brisbane. Australia. 

Brisbane Dermatologist
4.7 out of 5 stars 56 reviews

Eyelid Wrinkles/Bags -- Restylane or Belotero, Clear+Brilliant/Fraxel, Eclipse Micropen/PRP, Viva/Intensif, Botox/Dysport/Xeomin

While fillers would be recommended you could also do lasers, microneedling/PRP and  skin care/peels and botox to help this area. Please see an expert for an evaluation. Best, Dr. Emer

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.9 out of 5 stars 158 reviews

Many Options for the aging eye

Good afternoon - great question and thanks for the photos

While no treatment can actually turn back the clock a layered approach to your concern may indeed offer significant improvement.

In the photos you provided you can appreciate some elements of early aging and sun damage (enlarged pores, uneven brown color, resting fine lines etc) as well as the effects of smiling (deepening of the lines).

After a thorough assessment of your skin is completed likely a multifaceted regimen will be recommended. 

First of all you will need to practice safe sun with the use of broad spectrum UVA and UVB sunscreens. Many of these can be incorporated into your daily routine.

Next you will need to add medically supervised skin care products that contain Retinols and antioxidants as well as growth factors to help reverse some of the damage that has already occurred.

You can then move forward with neuromodulators (Botox etc) to slow the progression of fine lines. Lastly non-ablative Lasers like Fraxel can offer significant improvement in texture, tone and color, all with limited down time.

It's a great time of year to review your skin care and sun protection, reverse some of the summer's damage and move forward advanced products to protect you for years to come.

Take care (of yourself and your skin!)

Best of luck.

Dr Nodwell

Trefor Nodwell, MD
Ottawa Plastic Surgeon
4.4 out of 5 stars 10 reviews

Improving eye wrinkles

First off, fillers are what I would recommend with Botox. This is the mainstay of therapy for this area for your problem. Alternatives include Infini or CO2 laser resurfacing. I don't believe you will have much success with Fraxel or Ulthera because I've tried those and haven't seen much results.

Steven F. Weiner, MD
Panama City Facial Plastic Surgeon
4.6 out of 5 stars 26 reviews

Eyelid wrinkles

Your pictures demonstrate that you have fewer wrinkles at rest than when you are smiling.  There are two major elements contributing to those lines, the underlying texture/thickness/elasticity of your skin, and the motion that occurs when you smile.  Each can be addressed individually but the best results will be achieved if you treat them both.  There are several treatment options to improve the quality of your thinning skin, these include: topical skin care products, energy based treatments like Fraxel and Ultherapy, chemical peels, and ablative lasers.  Choosing which would be best for you will require a consultation with someone like a plastic surgeon who is experienced and has access to these various forms of treatment and who can offer a customized plan that is right for you.  I agree that fillers to this area would not be my choice, but Botox or another neuromodulator should help the lines that become more numerous when you smile, diminish dramatically. 

Isaac Starker, MD
Morristown Plastic Surgeon
5.0 out of 5 stars 5 reviews

Fraxel, eMatrix, Thermage, Botox, Chemical Peels

There are a number of ways available to rejuvenate the eye area. You don't appear to need fillers.  Lasers will correct this and improve this delicate eye area. Please consult a cosmetic dermatologist who is an expert with these procedures. Best, Dr. Green

Wrinkles around the eye and treatment options

You are a great candidate for Botox treatment of your periorbital lines (crow's feet). Usually, somewhere, between 12-24 units are required. I know you mentioned that you were not interested in fillers, but a softer filler like Belotero may help improve the shadowing under your eyes. Finally, a laser like Fraxel could improve the skin texture and some of the pigmentation you have but this could also in your case be accomplished with a good topical skincare regimen. Good luck!

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.