What can I do for the fine lines underneath my eyes: Lower eye lid lift? (Photos)

Question

I thought I could get restylane under my eyes and it would help. My dr talked me into juvederm but told me it won't hide all the lines but will make a big difference. Well..it really didn't help much. But Thank goodness she didn't put more than she did because I have read Horror stories about women developing really bad bags after juvederm injections under the eyes. What can I do about this? Is a lower lid lift my only option?

Kenneth D. Steinsapir, MD · Answer

Juvederm is a good product that is effective and has a place but not in the lower eyelid.  In my opinion it should also not be used along the lip edge.  Your eyes are beautiful.  If is essential that you not go out and do something that will damage your eyes and cripple you emotionally.  The lines are minor, and if you could like with them as they are that would be best.  However, if something needed to be done, I would start with a 35%TCA chemical peel.  Mind you I have not personally examined you so my opinion might change with an actual visit.  Does this mean that you should run out and get a lower eyelid chemical peel or a laser treatment?  You have to be careful.  Even individuals with very good credentials can get into trouble.  Many of the fractional laser treatments are mild so generally these are safe even if they do very little.Also I assume you are using an eye cream every day on this area which will provide mild help.  Good luck out there and stay safe.

Toby Mayer, MD · Answer

Treatment for under eye fine lines is not surgery! Chemical peels or laser resurfacing is what u need.

John J. Martin, Jr., MD · Answer

From the picture you present, you do not have significant eyelid lines.  what you are seeing is the crease just below the orbicularis muscle which helps you to blink and close your eye.  If these really bother you, you could try some laser resurfacing which should help to tighten the skin.  Surgery would help as well, but seems a bit extreme for the amount of excess skin you show here. See an oculoplastic surgeon for some advice.

Edward J. Bednar, MD · Answer

Before approaching the surgical route, a chemical peel or laser resurfacing may be a better option for you

Michael I. Echavez, MD · Answer

It is possible that fine lines under the eyes can be treated with surgery (lower eyelid lift) but it is also possible that they could be improved with laser resurfacing or a chemical peel.

Sean M. Blaydon, MD, FACS · Answer

I would agree with some of the others that you have only a few fine lines in your lower eyelids.  Based on the photo it appears you are young with few wrinkles elsewhere.  I suspect that your lower lid skin is thin with distinct lower lid creases that likely become more visible when you smile.  While chemical peels and gentle laser skin resurfacing can improve the overall quality of the skin I am skeptical that it will significantly reduce the appearance of these lower lid creases.  It is not too early to start using a topical retinoids, but again, it may not significantly reduce the appearance of these dynamic fine lines in your lower lids. While fillers such Restylane might be a good choice for reducing the appearance of tear trough (nasojugal) depressions over the orbital rim, that is not what we are looking at here.  These fine lines are your lower lid creases in thinner lid skin as the underlying orbicularis muscle contracts.  I would avoid any fillers under the thin lid skin above the orbital rims.The contour of your lower eyelids look beautiful and I would agree with others that surgery would not address your concerns regarding the fine lines and has the potential of ruining the appearance of your eyelids that might be difficult to fix.One option that has not been mentioned is the use of Botox in small amounts to gently relax the orbicularis and soften the appearance of these fine lines.  Only a consultation with someone experienced in these areas will determine the best treatment options for you.

Brian J. Lee, MD · Answer

Looking at your photos you have beautifully shaped eyes and minimal tear trough depressions. The wrinkles under your eyes are on the very delicate skin of the lid and injections will not correct this. Growth factors and retinol products in skin care will help, but takes time. Chemical peels, laser resurfacing and microneedling are effective ways to boost the effects faster, but a great skin care regimen will help to maintain the results for much longer.

Robert T. Buchanan, MD (retired) · Answer

Although the picture is quite poor, you have minimal lines under your eyes. A blepharoplasty would not improve you and would risk making things worse. Injection can occasionally improve this, but Juvederm is the wrong filler. It is hygroscopic, absorbing water, which means that the area can swell significantly. Restylane is less hygroscopic and, thus, causes less swelling, but Belotero is even better for this area. Another option for treating this area to reduce wrinkling is Retin-A that can thicken and tighten the skin.

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