What is the best treatment for deep dynamic under eye wrinkles? (photo)

this needs botox, plasma pen or lasers in the office. at home peels and dermarolling.

at home peels like cosmelan, enlighten and aerify along with dermarolling (emerageskin roller with anteage MD ampules) should be started now. 

There are many things you can do to treat under eye hollows and dark circles. A surgical option to remove skin and/or fat will such as lower eyelid blepharoplasty with or without fat pad repositioning will be the best long term. There are many things you can do to treat under eye hollows and dark circles without surgery. Non invasive less downtime options such as fillers, lasers, microneedling/PRP, cosmelan peels, and microneedling RF like Fractora or morpheus can all help give some improvement. Accutite can often be used or stronger lasers like erbium or co2 spot treatment can tighten the skin and give very quick improvement in wrinkles and texture. I suggest you get a formal consultation to see what is best for you and your goals. Best, Dr. Emer.

Hi, for deep under eye wrinkles can be treated with under eye fillers and botx together. If the wrinkles are deep, some fillers under wrinkles superficially can be helpfull

The use of fillers is an effective facial rejuvenation technique. It can smooth out folds and wrinkles. It will contour facial features that have lost their fullness due to aging, etc.

An in person examination would offer more information, but from your description it sounds like you would benefit from laser treatments potentially combined with fillers. You may also be a candidate for AccuTite treatments which use RF technology to tighten skin up to 40%.

It's difficult to give a complete response based on your photograph but in general fillers are less effective for any dynamic wrinkles. Fillers can be used with caution and in the hands of an experienced practitioner at the tear trough around the eyes. However, I recommend against filler treatment for the lower lid crease as this can make these wrinkles more prominent. Adequate treatment of this crease usually requires surgery. I would recommend an in person discussion with a board certified physician experienced in lower eyelid procedures.