What can be done for my under eye area? (Photo)

I have done botox and juvederm. I do like the botox but the filler never fixed how dark, hollow and wrinkled my under eye area looks. Just in the last 4 years my eyes have aged dramatically. Im only 38. The first picture is smiling. The last picture is me at 34!

Doctor Answers 9

Treatments for under the eyes

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Thank you for your question Casey13. Botox is a purified protein used to address wrinkles associated with facial expressions. Under eye circles can be treated with eye creams, fillers such as Restylane (to help the hollowing), and fractional CO2 laser treatments (to address wrinkles and crepey skin). Please consult with a doctor for specific recommendations. Good luck!

Try a C02 Laser Treatment

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It doesn't look like you have "bags" resulting from herniated fat, a more common under-eye concern. It appears that there is fine wrinkling in your lower eyelid skin. That would be best treated with a C02 laser. This will tighten the skin and reduce the fine wrinkles that are present. If one treatment isn't sufficient, a second can be performed about 6 months later. A blepharoplasty is designed to either remove or reposition the fat in the lower eyelids and is directed at "bags," which I do not believe is your issue. Thanks for your question, and best of luck.

Lower eyelids

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 Thank you for the question. I would definitely recommend CO2 laser resurfacing of the lower eyelid skin.  It does not appear that you have any fat herniation. Your issue seems to be related to scan only. Therefore, CO2 laser resurfacing would be the treatment of choice. One or two treatments, three or four months apart, would solve your issues.  Best of luck. 
Dr. David Mueller

David P. Mueller, DDS
Virginia Beach Oral & Maxillofacial Surgeon

Dark Circles, Eyelid Wrinkles/Bags Treatment -- Restylane or Belotero with Cannulas, Clear+Brilliant, Eclipse Micropen, Viva

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Skin care, lasers, fillers can all be done to improve this area. In my practice we add thermage for lifting and tightening.  Please see an expert who is experienced in treatment of this area.  Best, Dr. Emer.

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.8 out of 5 stars 207 reviews

Lower Eyelids

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Thank you fro your question. 

Based on your goals you may want to consider laser skin resurfacing. 

I'd recommend booking a consultation with a Board Certified Plastic Surgeon to determine what your best options would be.

Take care.

Lower eyelid

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Casey13, I would recommend a "SOOF lift blepharoplasty" with CO2 resurfacing of your lower eyelid. This procedure provides significant improvement for years and is quite safe. Search the Internet for a specialist familiar with this technique. Good luck!

M. Sean Freeman, MD
Charlotte Facial Plastic Surgeon
4.7 out of 5 stars 55 reviews

Treatment of under eye area

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I would consider a laser resurfacing procedure to help tighten the skin under your eyes and this possibly could help with the discoloration as well.  Fillers could help with any remaining depressions.   

Michael I. Echavez, MD
San Francisco Facial Plastic Surgeon
4.5 out of 5 stars 18 reviews

Lower eyelid

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Typically the first signs of aging involve the eyelids. And, like for most of us, can be largely attributed to genetics. A limited lower eyelid blepharoplasty-transconjunctival approach (which means making the incisions on the inside of the eye) can be an option. It can help with the puffiness of the eye which can be attributed to lower eyelid fat starting to protrude out. The best picture to see this is having a pic where you are looking up. On top of that, a pinch excision of the excess skin can be done to help smooth out the wrinkles on the skin. Talk to your PS for an examination. Hope this helps! -Dr. Miguel

George S. Miguel, DO
Troy Facial Plastic Surgeon


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Based upon your photo it appears that you have some loose and thin skin under your eyes.  You might want to consider some laser wrinkle treatment like the Farxel or CO2 laser system. It would be best for you to consult with a board certified plastic surgeon (facial, oculoplastic, or general) so that you could be examined and your optimal options could be determined.  Good luck!

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.