Best Procedures for Extremely Thin, Wrinkled Eye Area with Under Eye Hollows, Dark Circles and Crows Feet? (photo)

I am 33 years old and have an extremely thin, fair, combo skin. My main problem is crepiness under the eyes, deep under eye wrinkles and hollows, dark circles and crows feet. I started developing these at a very young age even though my lifestyle is very healthy (I stay out of sun, don't smoke etc..) I presume these are due to my skin being very thin. Can you please advise what procedures would be the best for me? I attached a series of pictures. Thanks a lot!

Doctor Answers 3

Thanks for the photos.

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Laser is not a good idea for you.  This precedes will only accelerate the thinning of your lower eyelid.  However, you appear to be a fantastic candidate for under eye fillers.  I personally believe restylane is the best of these products.

Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 26 reviews

Laser resurfacing or chemical peel

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Your skin type and problem is ideal for a laser resurfacing procedure. This will address the crepiness you describe and improve the general texture of the skin.

I would not use a CO2 laser, but rather a combination Erbium/CO2 laser that is more gentle and less likely to produce lower lid retraction.

Another less aggressive, but good option would be a strong chemical peel [trichloroacetic acid]. This is slightly less aggressive than a laser resurfacing, but may be enough for you.

Only an inperson examination can determine that however.

Be prepared to have pink skin for a few weeks to months after. And make sure you use SPF 45 or higher and stay out of the sun to prevent hyperpigmentation.

Good luck

A.J. Amadi, MD
Seattle Oculoplastic Surgeon
5.0 out of 5 stars 42 reviews


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If you look at risk benefit ratios your best bet is a combination of filler to the tear trough and botox of the crow's feet area. Some fillers can contribute to thickening of the skin overlying them.

My response to your question/post does not represent formal medical advice or constitute a doctor patient relationship. You need to consult with i.e. personally see a board certified plastic surgeon in order to receive a formal evaluation and develop a doctor patient relationship.

Aaron Stone, MD
Los Angeles Plastic Surgeon

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.