Late 30's and noticing sagging, loss of elasticity, crepey upper and lower eyelids. Hoping for tighter, smoother lids. (photos)

Botox is a good option to treat the crow's feet area, but it's not great for the under eyes. You can consider some filler to help with volume loss. Another helpful option is Morpheus8. This treatment uses RF technology combined with microneedling to improve overall skin tone and texture. It is safe to use around the eyes. We always recommend using medical grade skin care products like Transform MD and wearing sunscreen every day. I've included a video I hope you find helpful.

Morpheus 8 is a non-invasive skin and soft tissue tightening treatment that is consistently amazing in our patients. We use the Morpheus to exact fractional induced RF into the skin or tissue in order to tighten collagen and stimulate contraction of the tissue. For acne scars, it is quite useful to build collagen in patients who have atrophic scars but is not very productive for ice-pick scars which require TCA Cross. For tissue tightening, Morpheus is ideal for the face and neck and we often combine it with CO2 laser or Ultherapy to further enhance results. Chemical peels and skin resurfacing should be done at least 5 to 7 days after, but can be performed earlier, depending on treatment severity. Avoid exfoliating skin treatments before Morpheus and expect a period of 2-4 weeks for skin contraction to set in.

Best,
Dr. Karamanoukian
Realself100 Surgeon

This is a frequent concern that is best addressed by a combination of treatments.  Lower eyelid TCA peels can be done in isolation without treating the entire face. The lower eyelid skin usually peels quicker, but there is still about 5 days of downtime.  I combine this with Dysport in small (diluted) doses and PRP.  All of these are not done at the same time, but over time depending on the ability to have down time.  I know you mentioned your skin care is the best, but I would also recommend using HA5 over your skin care products for instant hydration and continued improvement. 

I suggest a combination approach with lasers, fillers,skin care and microneedling/PRP. Please seek an expert for a consultation. Best, Dr. Emer.

Botox is great for active wrinkles such as crow's feet but treating aging eyes typically involves a combination of non-surgical treatments such as fillers for the under-eye/cheek transition, lasers for skin tone and texture and an RF treatment such as ProfoundRF for skin tightening.