Retin-A or Fillers for Hollow, Under Eye Circles and Wrinkles?

I've had issues with tear trough dark circles for as long I can remember. But due to both smoking and tanned in the past, I'm seeing more issues now that I'm in my late twenties. I'm only 28, but my eyes are more hollow and wrinkles have appeared too. My crows feet are not very pronounced, but the static wrinkling under my eyes is very bad! Add the three together, and it makes me look tired and much older than my 28 years. What would be my best course of treatment at my age? Retin-A, fillers or something totally different?

Doctor Answers 11

Start with Renova and Lumierre

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The main problem is the poor texture, so I would begin with Lumierre eye cream twice daily, and Renova on top of that every night. Be sure you sleep on 2-3 pillows on your back and if you have sinus problems or allergies take an antihistamine decongestant every day. After 3 months, if you do not have great results, I would suggest an Active FX laser treatment instead of injecting fillers.

New Orleans Dermatologist
5.0 out of 5 stars 18 reviews

Undereye circles/depressions

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The depressions can be improved with small volumes of Restylane filler injections (my choice of filler for this area), while the purple/blue discoloration may benefit from topical cosmeceutical products containing caffeine. If you have any allergy symptoms, antihistamines might help with the blue/purple discoloration; if not, vascular lasers may be beneficial.

Good luck.

Bryan K. Chen, MD
San Diego Dermatologist

Botox for crow's feet and lower eyelid wrinkles

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I think the above physicians focused on the first paragraph instead of the second. There are 3 issues of concern to you:

  1. the hollowing of the eyes
  2. the wrinkles on the lower eyelid
  3. the crow's feet

The degree of hollowing cannot be assessed from this photo.

The wrinkles on the lower eyelid are really dynamic lines that are produced by the muscle that brings the upper and lower eyelids together. In the absence of excess skin there is nothing currently available to effectively address this. If there were excess skin you could remove it together with the wrinkle. Chemical peels and lasers do not really work because their result is temporary and continued movement of the muscle leads to early recurrence of the wrinkle. You can't Botox it because of the risk of the eyelid drooping down (ectropion) with tearing etc. If the muscle is over acting from squinting the options are glasses, contact lenses, lasik, sunglasses, stop smoking, etc depending on what the root cause of the squinting is.

For crow's feet the best current treatment is Botox. We don't even have any surgical technique that works as well for this area.

Aaron Stone, MD
Los Angeles Plastic Surgeon

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Fillers work well for tear trough depressions

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Fillers such a Restylane, Juvederm or diluted Radiesse work nice for under eye depressions but usually need to be done in 2-3 sessions a few days or a week apart at a cost of roughly $550-650 per syringe and usually 2 syringes needed. 

Retin A is always a good thing to use to keep the skin healthy.

David Hansen, MD
Beverly Hills Dermatologic Surgeon
4.7 out of 5 stars 46 reviews

Fixing under eye circles / depressions

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The areas you are referring to, the Tear Troughs (Or the nasojugal lines) are best treated with Restylane filler expertly placed close to the lower rim of the eye socket. This will lift the depression and unify the lower lid cheek complex greatly improving it. I would recommend you have it done by a MD, not a subordinate injector.

Good Luck.

Dr. P. Aldea

Peter A. Aldea, MD
Memphis Plastic Surgeon

Tear troughs and wrinkled skin

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It sounds like what you need is both volume replacement for the tear trough, and skin treatments like Retin A plus stopping smoking and sun protection.  Skin surface treatments and volume enhancement are not mutually exclusive. 

Fine periorbital wrinkles and hollowness

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Minute amounts of Botox selectively in offending muscle fibers, and very careful use of a Retin-A type medication suitable for your skin type, along with very careful filler (only hyaluronic acid) would be your best bets for these minor problems,

Because every patient is different, there is no single hyaluronic acid that is right for all patients. We use a graduated process from lighter HA's to heavier ones in the under eye area.

Brent Moelleken, MD
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 194 reviews

Correction of undereye circles or bags with fillers

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Any hyaluronic filler can be used. Overcorrection can produce fullness or a bluish appearance to the area. This should be injected by an individual who has alot of experience with the technique.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 86 reviews

Fillers for hollowing, Botox or Dysport for wrinkles

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The hollowed area (so-called tear tough deformity) is ideally handled with one of the hyaluronic fillers- eg restylane, perlane etc

The filling combined with minute doses of botox or dysport for the fine wrinkles and crows feet should be ideal.

The treatment takes only a few minutes, is essentially painless and lasts for months

PS don't forget your sunscreen!

J. Timothy Heffernan, MD
Seattle Oculoplastic Surgeon
4.6 out of 5 stars 12 reviews

Tear trough, wrinkles

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For tear trough hollowness Injection of Restylane filler or FAT TRANSFER is your best treatment.

For the pigmentation and fine wrinkles the best treatment is laser resurfacing, which treats both. Other options for the pigmentation is OBAJI skin care and chemical peels. Chemical peels can help the fine wrikles some too.

Samir Shureih, MD
Baltimore 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.