What's the best treatment for my dynamic under eye wrinkles? 58 y/o (photos)

Question

Hi! 58, fair skin F. Skin is not sensitive. In general I don't have a lot of wrinkles, but I am very bothered by my under eyes when I smile. Contact lens wearer since age 15, so a lot of tugging the skin in that area. I don't have dark circles, eye bags, or marked tear troughs, but the wrinkling is awful. Pictures shown with recent Botox as far under eye as an injector will go. I won't do HA under eye filler as too risky, but considering PRF. Would deep peel help? Or lasers? Ty!

Raffy Karamanoukian, MD, FACS · Answer

Our treatments use combination therapy to improve the epidermis and dermis for most deep scars. The options available for acne scars depend on the character of your scars, in terms of topography and contour. We see atrophic and hypertrophic acne scars, as well as scars that have hypo and hyperpigmentation. We begin each scar evaluation with an assessment of scar quality and subtype. Our main concern is rebuilding collagen and that is why we use a HIDEF protocol that includes combination therapy. Morpheus 8, scar subcision, fibrous release, fractional laser, CO2 laser, Thulium laser, PDL Vbeam laser, and fractional resurfacing can be used in addition to TCA Cross and chemical peels to further improve skin. Patients should start Melarase AM and Melarase PM for active hyperpigmentation. Always begin with a consultation to decide whether early subcision should be started.

Best, 
Dr. Karamanoukian 
Realself100 Surgeon

Vincent Gardner, MD · Answer

Hi sdfusion,Dynamic under eye wrinkles are normal. As we age and lose collagen and elastin, they tend to be more pronounced. Treating the skin would be helpful especially if you are concerned about adding volume with injectable fillers. The more aggressive you are with a laser or peel typically means the better result you will get long-term. I tend to prefer either fractionated CO2 or a deep chemical peel, such as a Croton oil peel. These treatments can be repeated if needed to further effect change. Doing less aggressive treatments that are typically offered by med spas can be helpful, but they typically require more treatments. Unfortunately the only way to know how you’re going to respond is to have treatments and give yourself some time to recover and see if you’re happy with the results. If you start out with minimal treatments and don’t get the results you want you can always step it up to the more aggressive treatments. Good luck.

Oakville Plastic Surgery &amp; Medspa · Answer

This area under your eye can be treated with botox. I treat many clients for the same reason you are asking. Filler would not make sense even if you were willing to proceed. Perhaps seek an injector who is more experienced with this type of injection as the result is beautiful, and considerably less expensive than seeking out alternative options.

What's the best treatment for my dynamic under eye wrinkles? 58 y/o (photos)

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What's the best treatment for my dynamic under eye wrinkles? 58 y/o (photos)

Answers (3)

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