What will help improve my under eye area-Restylane, Botox, or a lower blepharoplasty/skin pinch? No lasers please. (photos)

Question

46 yo female, have gotten Botox in past for crow's feet. In April, went to ocuplastic surgeon and had Restylane under eyes for hollows. 11/1/16, got Voluma in cheeks, but no Restylane under eyes. Within a few weeks, I had wrinkles under eyes that weren't there before. I have crepey creases with some puffiness. On 11/29/16, went back to same surgeon and he put small amount of Botox under eyes, but it is much worse. So upset. What could help to smooth out my under eye area?

Kenneth D. Steinsapir, MD · Answer

It is making you look old and haggard rather than beautiful and wonderful.  Don't talk yourself into more funky service and ill conceived surgery.  That will wreck you.  I recommend seeing a cosmetic surgeon who really understands these issues and have them take out all the volume that is filling up your face and making you look older.  You probably also need the poorly done under eye fillers removed as well.  Once this is done, judicious use of filler will help restore the heart shaped face. You forehead botox is also freezing the face and making it look inauthentic. I also think you have upper eyelid ptosis and this is some thing that will benefit from being addressed.

Kian Karimi, MD, FACS · Answer

Thank you for sharing your question and photos. You appear to be an excellent candidate for full field laser resurfacing to your periocular (eye) area. I have had excellent success using this treatment to reduce the appearance of “crepey” skin around the eyes and improve overall texture and laxity. While there is some downtime associated with this procedure, the treatment offers long lasting results that will restore youthful skin. I would also recommend a resurfacing laser treatment called Halo for the rest of your face to improve the appearance of fine lines, brown spots, and pore size. This treatment also reverses sun damage and will improve your overall skin health. Both the Halo and periocular resurfacing can be done at the same time. After your skin quality has improved, you may benefit from a combination of Botox and fillers. For more information about which procedures are right for you, I recommend consulting with a board-certified specialist.

Kyle Coleman, MD · Answer

Swelling and exacerbation of wrinkles of the lower lid can happen if attention is not paid to the volume changes around the eye.  By filling the cheeks, there is upward pressure on the lid an accentuation of the orbital hollows.  From your pictures, you would be best served by placing some filler on the lateral portion of the orbit with small amounts of botox on the lid itself.  Some filler in the mid cheek may need to be dissolved in order to create a more natural look.   Seek out an expert in facial injectables.  When in doubt get multiple opinions.  Best of luck.

Jeanine B. Downie, MD · Answer

Hi There,Restylane under your eyes will improve the appearance significantly.  I understand from your question that you are not interested in Fraxel, however, this will help to resurface your skin as well.  Finally, you should be using a top notch sunscreen such as Total Defense & Repair from Skin Medica everyday all over your face with re-application including under your eyes.  Good luck, Dr. Downie

Estee Williams, MD · Answer

This is a commonly reported problem. Crepiness under the eyes, worse with animation. I would recommend treatments that safely tighten the skin.  These include: Fraxel laser, microneedling, microneedling with radiofreq combo (Intensif, Infini), or a TCA-25% peel.  Downtime for these treatments varies from 1 week (Fraxel) to 48 hours (microneedling).  You mention that you do not want lasers which would exclude Fraxel, although you are a good candidate for that.  I would also recommend that you discuss with your injector the possibility of reversing some of the Voluma that is seen immediately below that crepey skin.  Be well!

What will help improve my under eye area-Restylane, Botox, or a lower blepharoplasty/skin pinch? No lasers please. (photos)

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Answer: What will help improve my under eye area-Restylane, Botox, or a lower blepharoplasty/skin pinch

Answer: What will help improve my under eye area-Restylane, Botox, or a lower blepharoplasty/skin pinch

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What will help improve my under eye area-Restylane, Botox, or a lower blepharoplasty/skin pinch? No lasers please. (photos)

Answers (7)

Answer: What will help improve my under eye area-Restylane, Botox, or a lower blepharoplasty/skin pinch

Answer: What will help improve my under eye area-Restylane, Botox, or a lower blepharoplasty/skin pinch

Answer: Consult

Answer: Consult

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Everything you need to know about Restylane

Our mission is to create a world where every investment in modern beauty is Worth It.