Best treatment options (surgical or non-surgical) for thin, crinkly under eye skin within orbital bone? (Photo)

Retinoids (Retinoid Repair Cream) and IPL and Botox can help with the wrinkles around the eyes and can help build needed collagen to the area. Best, Dr. Karamanoukian Los Angeles

There are various treatments for fine lines around the
eyes. Lasers are the traditional treatment to tighten the skin but now we have fillers that can be used off
label that are proven
to be helpful in this area. Also, a very low dose botulinum toxin
type A can relax the muscle that contributes to the wrinkles. Sometimes
we even perform surgery to remove a little extra skin. However,
with the help of minimally invasive treatments such as ThermiSmooth and
Ultherapy, we are now achieving excellent
results by stimulating collagen and creating
skin tightening. It's difficult to specifically address your issue
without examining your face so seek out a specialist in minimally invasive
treatments around the eye. This is a delicate area to treat with fillers
and if not performed correctly it can get lumpy.

The eyes are the windows to the soul. All too often,
however, they seem to reveal exhaustion. The very delicate skin around the eyes
tends to get crepey and puffy due to fatigue and stress. An effective
non-surgical option that might benefit you is Thermage, which
can tighten the skin around the eyes. The new and improved Thermage is a virtually
painless, non-invasive (no incision!) treatment that can tighten skin and
stimulate your body to make healthier collagen—the building block that provides
structure to your skin. Fast and easy, Thermage requires no downtime from
normal activities.

I my opinion, laser resurfacing is the gold standard for wrinkles around the eyes.  It is critical to have the procedure performed by an expert to avoid unwanted complications.  Correctly performed, both CO2 and Erbium can produce great results.

I have lectured about this extensively. In my opinion - there is nothing better then the Sciton full field  (also called TRL, variable pulse width or deep erbium) resurfacing for under eye loose skin - especially in younger patients. Go on the sciton website or mine to see many many results.As for the Sciton Halo - we helped develop this technology and its is fantastic - just not the best device for under eye wrinkles. Its great for skin rejuvenation, pigment and nothing beats it for pores but for under eye tightening I prefer the resurfacing component of the Sciton

We have a new procedure called "The Time Machine" which is a proprietary treatment protocol that improves the skin texture with minimal downtime.  We use radiofrequency to fractionally resurface and tighten the skin along with 2 other procedures to increase collagen production.  We've had great results, especially with the thin skin around the eyes.