Recommendations for helping under eye wrinkles and skin texture?

I tried restyling but it only made it more apparent. I believe it was over filled. I now have loose skin. I have large cheeks so when I smile all the skin wrinkles up under my eyes. I have no lines or wrinkles anywhere else but apparently it ages me a lot as people think I'm 10 years older than I am. I also have giant pores causing issues trying to put on make and awful skin texture. Some foundations and a lot of face lotions peel and ball up off my skin. I'd like recommendations.

Doctor Answers 5

Concerned About Under Eye Wrinkles, Looking Older for Age, and Large Pore Causing Makeup Problems

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A comprehensive evaluation of the periorbital area shows if the problems related to looking older are due to excess wrinkling due to texture or excess skin, hollowing under the eyes that may be accompanied by fat atrophy and descent of the cheek and loss of fat under the brows.  These are treated with one or more of the following: fractional ablative CO2 laser around the eyes and crows' feet, volume restoration with the patient's own fat to replace lost volume of the upper cheeks and the area under the eyebrows and temples, or fillers such as restylane and radiesse for the cheek volume loss.  Fat grafting is permanent, and fillers are temporary. The results from skin resurfacing with the CO2 laser are a smoothing of wrinkles and tightening of the skin. A good skin care regimen will reduce oil production of the sebaceous glands and the pores will gradually shrink. We use the ZO program with retinols, and exfoliants to accomplish this over a 3-4 month period.

Mountain View Plastic Surgeon
5.0 out of 5 stars 54 reviews

Under Eye Skin Treatments

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Hi and thank you for your question! The under eye skin is very prone to thinning and fine lines/wrinkles. To treat this issue non-surgically, we often recommend some type of laser or energy based treatment to stimulate collagen and improve the texture. We decide which treatment based on several factors including the amount of downtime you can have, your skin type and the condition of the skin. The treatments we choose often include the Sciton Contour, Sciton Halo or Venus Viva. Feel free to call our office and/or come in for a complementary consultation! Best, Dr. Grant Stevens

Grant Stevens, MD
Los Angeles Plastic Surgeon
4.7 out of 5 stars 152 reviews

Under eye wrinkles and skin texture

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It is best to have a in-person physical examination by a plastic surgeon to determine the exact nature of your eye wrinkling and texture issues. Generally speaking, injectable filler and fat grafting are options to help smooth a mild amount of loose skin, improve texture, and reduce hollowing/shadowing around the eyelids. If too much hylauornic acid filler is injected, it can be quickly dissolved with hyaluronidase. There is minimal downtime but it will last for less than a year before you need more filler injected. For permanent results, fat grafting can be performed. For patients with more moderate to severe loose skin or hollowing/wrinkling around the eyes, eyelid surgery can help eliminate and tighten loose skin while repositioning or removing excess fat to help smooth the lower eyelid and cheek areas. For the best treatment options, it is important to visit an expert for an in-person examination. Hope this helps!

Johnson C. Lee, MD
Beverly Hills Physician
5.0 out of 5 stars 17 reviews

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Treatments for under eye skin

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Hello!  Under eye wrinkles are a very common concern.  They are also one of the more difficult areas of the face to treat noninvasively.  The reason for this is simple:  Generally speaking, there are 3 things which drive the aging process:  (1) muscle contraction, primarily in the upper face, can cause expression lines to be come etched into the skin.  (2) volume loss along the cheek bones can lead to hollowing under the eyes, and lines of the lower face.  (3)   The skin itself becomes weak and  stretchy with time due to loss of collagen.  Underneath the eye all 3 of these things come together to create the perfect storm.  Therefore, non invasive treatment for under eye wrinkles can be complicated. In my experience, the best results come when you address all 3 of these problems one at a time.  Botox can be used directly under the eye.  It will help some, approximately 10-15%, but do not expect a miraculous change from it as the muscular contribution to these lines is a relatively small.  Filler can also be used, especially around the outside edge of the eye (I generally place very little to no filler directly under the eye as this is an area where it is difficult to get a smooth, natural appearing result), and by lifting the skin, can help "fill out" some of these lines as well.  However, because you cannot place filler above the bone that surrounds the eye socket, there is a limit to how much benefit you can get from filler in that area.  The third thing you can do is to stimulate the skin to grow more collagen, so that has the ability to stand up to gravity better, which will reduce those lines.  There are many treatments which increase collagen in the skin, but they have one thing in common:  skin will regrow collagen, but only when it thinks it has been wounded.  Therefore, all collagen increasing treatments are based on the concept of the controlled wound.  You do something to the skin, create some small amount of damage, and the skin responds by growing more collagen.  Lasers use heat to create this controlled wound, peels use acids, and microneedling uses physical puncture, however, they are all "getting at" the same healing response.   For under eye line such as yours, I generally recommend  a series of collagen building treatments such as microneedling, which can go all the way to the lash line (and will also address you enlarged pores), followed by a small amount of Botox, and a Filler such as Voluma.  This can have a wonderful results, but does require time, and commitment to the treatment course.

Flora Waples, MD
Denver Physician

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

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The eyes are best treated with a combination approach of fillers, lasers, microneedling/PRP for improvement. My patients love fraxel or clear and brilliant with microneedling for pores. I would suggest consulting a board certified dermatologist.  Best, Dr. Emer

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

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.