Post under eye lift - bad dynamic wrinkles (Photo)

Thank you for sharing your concern and congratulations on your recent upper and lower eye lift. It's understandable to feel frustrated with persistent under-eye wrinkles, especially when you've already undergone surgery. Here are some potential options to consider for improving the dynamic wrinkles under your eyes:

Botox:

Effectiveness: Botox (or other neuromodulators like Dysport or Xeomin) can be very effective in reducing dynamic wrinkles, which are wrinkles that appear when you smile or make other facial expressions.
Mechanism: It works by relaxing the muscles responsible for these wrinkles, resulting in a smoother appearance.
Considerations: Botox is a temporary solution, typically lasting 3-4 months, and will need to be repeated to maintain results.
CO2 Laser Resurfacing:

Effectiveness: CO2 laser resurfacing can improve skin texture and reduce fine lines and wrinkles by promoting collagen production and skin tightening.
Recovery: This treatment involves some downtime, with redness and swelling lasting several days to weeks, depending on the depth of treatment.
Considerations: It's important to have this procedure performed by an experienced provider to minimize risks and achieve the best results.
Microneedling with Radiofrequency (RF):

Effectiveness: This treatment combines microneedling with RF energy to stimulate collagen production and improve skin texture and elasticity.
Recovery: Downtime is typically minimal, with some redness and swelling for a few days.
Considerations: Multiple sessions may be needed to achieve optimal results.
Fat Grafting:

Effectiveness: Fat grafting can add volume and improve skin quality around the eyes. It involves harvesting fat from another area of your body and injecting it into the under-eye area.
Considerations: This is a more invasive procedure compared to fillers and can provide longer-lasting results. However, the success of fat grafting can vary, and some of the grafted fat may be reabsorbed by the body over time.
Topical Treatments:

Retinoids: Prescription retinoids can improve skin texture and reduce fine lines by promoting cell turnover and collagen production.
Peptides and Growth Factors: These ingredients can support skin repair and rejuvenation, potentially improving the appearance of wrinkles over time.
Future Procedures:

Face and Neck Lift: When you are ready for a face and neck lift, this procedure can provide more comprehensive rejuvenation, addressing sagging and wrinkles in multiple areas.
Combination Approaches: Combining surgical and non-surgical treatments often yields the best results. Discussing a comprehensive plan with your surgeon can help you achieve your aesthetic goals.
It's essential to have a thorough consultation with a board-certified dermatologist or plastic surgeon who can evaluate your specific concerns and recommend the most appropriate treatments for you. They can help you weigh the benefits and risks of each option and develop a personalized plan to address your under-eye wrinkles.

Best regards,

Dynamic wrinkles botox. If static wrinkles, CO2/good skincare. If both, do both. :) You said it yourself!

Thank you for your pictures and questions. If your surgeon has already removed skin in that area, then I would avoid additional skin removal as this can possible cause problems like ectropion, so I would agree with him/her there. If this wrinkling of the skin is only when you animate/smile, then it could be due to bunching of the muscle in that area and it might be softened somewhat with a small injection of Botox in that area. This can work for some people and not so well for others but is worth a shot as it is easy to try and carries minimal cost and risk. You could also consider a deep laser resurfacing treatment (we prefer Sciton Contour TRL) to tighten the skin and treat superficial blemishes and fine wrinkles.
Hope this helps!
Dallas Buchanan, MD
VIVIFY plastic surgery
Tampa, FL

I mean if this is an area that you notice when you smile there is defenitely dynamic muscle movement going on that is forming the wrinkle which means that botox may help you improve that infraorbital area. I would be conservative and do 1 unit each of botox to see if that can help but just be careful I think sometimes we have to accept it will never be 100% perfect than keep on looking for different procedures and then end up with undeyes now that are unfixable.., you have to be careful when filling the under eye with blocking lymphatics that go around your eye as that can lead to more swelling.

It's best to determine if you are a good candidate for Botox under the eye when seeing the eyes with and without smiling. A small dose of Botox can be used to soften the muscle that hugs the eyeball, but this treatment is not for everyone. You could also consider other treatments such as Morpheus8 to improve the appearance of the under eye.