40 years old. Have Botox for Crow's feet but what would you recommend for crepey, hollow, wrinkly area under the eyes? Was told fillers are difficult. Have tried TCA peel, not very effective. Fat injection? Laser? Any suggestions would be greatly appreciated. Very self-conscious & tired of looking tired.
Best Remedy for Crepey Skin Under Eyes? (photo)
Doctor Answers 6
Crepey lower lid skin
If you have tried TCA without results, you may benefit from a lower lid skin pinch blepharoplasty with light laser treatment. I don't think fillers or fat grafting will be beneficial. Schedule a consult to discuss your options.
You do have some mild volume loss, but the primary issue is skin laxity. CO2 laser can be helpful to improve the appearance but will not appreciably change the skin quality.
We have been combining two radiofrequency technologies to treat exactly this problem and are seeing dramatic changes. A superficial radiofrequency device such as sublative will stimulate collagen and improve texture. We combine this with ePrime, which delivers radiofrequency to the deeper skin layers and stimulates elastin, collagen and hyaluronic acid production. This provides an amazing result without surgery.
Treating Under Eye Wrinkles
For the crepiness under the eyes fractionated Co2 treatments work best ( I prefer the fraxel repair or active/deep fx). I would not advise the use of fillers above the orbital rim, as the skin is thin and sometimes product can be seen through the skin, fat would be more appropriate in this area if there is true volume loss. If there is a "tear trough" then hyaluronic acid products work very well.
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Crepey Loose Lower Eyelid Skin
There are surgical methods to improve the lower eyelids. Other options include lasers and chemical peels.
Treatment Recomendations for Lower Lid Wrinkles, Crepiness, and Hollowness
First I would address the reason for these lower lid and crows-feet wrinkles.These type of wrinkles are often seen in patients that squint so first of all I would make sure that if you need visual correction then use glasses or contacts (if not sure, have your vision tested) and use sunglasses on bright days. Now for treat options, use of fillers like Restylane and Juvederm are helpful to decide the degree of benefit from supporting the skin. If you like the effect then consider a more permanent solution like fat transfer. Secondly, a deeper TCA peel, or fractional laser often helps. Both fillers and resurfacing procedures are complementary and synergistic in your case. For redundant skin, a conservative skin pinch blepharoplasty may also be of benefit. A qualified board certified aesthetic surgeon will help you find the right treatment for you.
Profractional Resurfacing and Restylane
Hi Wannabeme4me. We would use a combination of Sciton Profractional laser resurfacing and Restylane. The resurfacing procedure would have about 7 days of downtime, but when used with coagulation (deep tissue heating) can give you some really nice tissue tightening and refirming under the eyes. For the volume loss, we would suggest Restylane. Both of these would help with the wrinkles under the eyes.
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