I have been having a hard time getting results with Botox. What can be done for line and wrinkles under and above eyes? (Photo)

Doctor Answers 7

Try ThermiSmooth Eyes

ThermiSmooth RF (Radio Frequency) might be a great answer for you. ThermiSmooth is done in 6 treatments scheduled every 2 weeks. Results can be seen in 3 to 6 months with continued improvement up to 10 months.  At Key Laser we use Oculoplastic Eye Shields to be able to treat the entire eye, including the eyelid. 

Portland Dermatologic Surgeon
4.5 out of 5 stars 15 reviews

Treatment of Wrinkles in Eye Area

Hi and thank you for your question!

The skin around the eye is so thin and prone to these fine lines and wrinkles. We have seen some nice results in this area with our Venus Viva fractional radiofrequency treatment. Since its not light or laser, we can bring it right up to the lower lash line, and even above the eyelid, over the orbital bone to treat that skin. In addition, another treatment that can help lift the eyes, relieving some of that skin, is Ultherapy. These two treatments work wonderful in combination.


Dr. Grant Stevens

Grant Stevens, MD
Los Angeles Plastic Surgeon
4.7 out of 5 stars 121 reviews

Pro-Fractional Laser/ Laser / Resurfacing / Eyes / Wrinkles

Thank you for your inquiry. If the area around your eyes isn't responding well to botox, Peri Orbital Pro-Fractional Laser resurfacing may be an option for you. Pro-Fractional Therapy is a quick and comfortable laser procedure with little downtime, used for improving the overall appearance of your skin.

Facial Resurfacing covers only a small portion of the total treatment area, leaving the surrounding area intact as opposed to full field resurfacing which removes the entire surface area. The treatment uses a laser micro-beam, which creates a multitude of tiny, isolated channels in the skin. This difference results in collagen and elastin stimulation, fibroblast activation, and encouraging of rapid healing.

Be sure to consult with a board certified plastic surgeon for best results. Regards,

Fine lines under eyes won't respond to Botox

These fine lines won't usually respond to Botox. I would maximize your topical therapy with Retin A and a good eye cream. Laser resurfacing, Infini, and or fillers will also help. 

Steven F. Weiner, MD
Panama City Facial Plastic Surgeon
4.6 out of 5 stars 26 reviews

I have been having a hard time getting results with Botox. What can be done for line and wrinkles under and above eyes?

Thank you for sharing your question and photograph.  If Botox is not helping to improve your crows feet and lower eye region I would recommend filler placement with a hyaluronic acid filler such as belotero or restylane. For skin along the upper eye there is little nonsurgical options but an upper eye blepharoplasty can be performed to remove the lax, excess skin.  Hope this helps.

Nelson Castillo, MD
Atlanta Plastic Surgeon
5.0 out of 5 stars 38 reviews

Under Eye Wrinkle Treatments

Dear dawnoftexas:

Looking at your photos, I would recommend fillers like Teosyal Redensity II for your tear trough along with possible chemical peels, lasers and maintenance topical retinols.  All the best.

Let's Try Something Else--Under-Eye Wrinkle Treatment, Lasers, Microneedling/PRP, fillers

Fillers, lasers, microneedling/PRP can help this area. I suggest you see an expert for a formal consultation. Best, Dr. Emer.

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.9 out of 5 stars 159 reviews

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