What treatment would you recommend for fine lines and wrinkled skin under my eyes, in my tear duct area and my upper eyelids?

Fractional laser is an amazing and highly effective treatment in our office. We use the laser treatment to help with acne scars, large pores, fine wrinkles, tissue collagen loss, scars, sebaceous hyperplasia, active acne, and for brightening dark pigmentation. Although there are very strong fractional lasers such as CO2 laser, we use lighter treatments for corrective skincare and maintenance of results. Our Thulium fractional laser, clear and brilliant laser, and Ultra Thulium laser are excellent options in our clinic. We also perform CO2 fractional and erbium depending on skin tone and tolerance for downtime. Patients do have to use a Melarase cream before and after treatment to help further reduce pigmentation after laser. Melarase AM, Melarase PM, and Melapads can seriously improve surface sun damage and UV related pigmentation. Dark spots can improve with these treatments. I recommend fractional laser for incisional scars as well, especially after plastic surgery.
Best,
Dr. Karamanoukian
Realself100 Surgeon

There are several options to improve and rejuvenate the area around the eyes.  The volume can be replaced with fillers in the tear trough area.  The texture of the skin under the eye can be improved with chemical peels, lasers, or microneedling, but if these types of treatments tend to make pigment problems worse, then you may be interested in surgical options. In many cases, blepharoplasty (eyelid surgery) can achieve beautiful results with minimal down time. This applies to both the lower eyelid and the upper eyelid areas. An in-person consultation can be very helpful to determine the best options and review them in detail.All the best,

Thank you for your question. Fillers work well in the tear trough area. Juvederm is my filler of choice. Ultimately, a consultation is required. An experienced provider can best advise you as to which treatment is best for you. 

I would consider performing a traditional CO2 laser. I have been using it for twenty years with excellent success in improving lines around the eyelid region. One of the beneficial side effects of the CO2 laser is actually lightening the skin of the eyelid area. The downside is a two week healing process and the skin can remain pink for several months requiring a light concealer. I would consult with a facial plastic surgeon in your area.

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. Best, Dr. Emer

Hello and thank you for your question.   Based on
your photograph, you may benefit from a lower eyelid blepharoplasty with septal reset.  Less invasive procedures such as fraxel or fillers will not work as well for you.   Make sure you specifically look
at before and after pictures of real patients who have had this surgery
performed by your surgeon and evaluate their results. 
Best wishes and good luck.
Richard G. Reish, M.D.  FACS
Harvard-trained plastic surgeon

Well fortunately with all the latest advances in esthetic medical procedures you have a lot to choose from.  The simplest of course is to start with some Botox around the eyes.  The rest are numerous and I would definitely consider a CO2 treatment around the eyes such as the Madonna Lift.  If you need some treatment for the hollowness around the eyes Bellafill with the use of a fine canal also works great.  If you just need some tightening a skin tightener such as the Ellman  Pelleve works great.  If you have a lot of extra skin a surgical Blepharoplasty may be an option also.  Just remember that every patient has a different set of needs and expectations,  and what would make one patient extremely happy may not please another patient.  So be sure to tell your physician exactly what you are looking for in a procedure and how aggressive you want to be with any type of treatment.

You can try a combination of PRP injection under the eyes in combination with fillers.  You also can use eye cream daily and some radio frequency.  Remember a combination of all of these will help you get the best result.  Be sure to contact a board certified plastic surgeons office in your area.  Best of luck to you.

I would recommend a neurotoxin injection (Botox), which will help soften and prevent wrinkles (crow's feet and inferior eyelids). The fine lines (tear troughs) can be treated with filler and microneedling with platelet-rich plasma (PRP), if you want to avoid laser resurfacing. 

I would recommend eMatrix for the fine lines under the eyes.  There is little down time for this procedure and a small amount of Belotero or Restylane in the tear trough placed well will help improve this area a great deal.  Thermage and Exilis also tighten the area around the eyes and rejuvenate and tighten the skin.  Please consult an expert in anti-aging treatments.  Best, Dr. Green