I'm ready for a facial overhaul. Now what to do about my eyes? (Photo)

Question

I'm only 24 and take care of myself but I have crows feet and sunken in eyes. I'm considering botox for crows feet. I don't really want to start using fillers. I've heard of fat grafts for sunken eyes but I've heard this can result in lumps and may not last for long. The ridges near my nose have become very deep. TYIA.

Michael A. Persky, MD · Answer

Hi NewLease,No major overhaul necessary!  Stay away from fat grafts at your young age.  You should be evaluated in person for possible placement of Restylane in your lower eyelid hollows.  The best treatment for crow's feet is Botox or Dysport, though again at your age you probably don't need it.  We have lyrics to Burno Mars', "Just the Way You Are" in our consultation room to hand out to patients like yourself at the end of our consultation.  Enjoy your youth while it lasts!  You must be very careful who you choose to see about your complaints to avoid someone performing unnecessary treatments for monetary gain.  Good luck and be well.Dr. P

Jason Emer, MD · Answer

Avoid many surgeries or fat grafting/transfer at your age.  You have beautiful skin and have very little that needs to be changed.  If you want to prevent aging, some filler in the eye hallows or small amount of neurotoxin on the crows feet wont hurt; and are safe since they are not permanent.  Fat transfer can be unpredictable and can lead to asymmetries or granulomas in the future, you don't want this.  Starting light peels or Fraxel laser at your age isnt uncommon and can tighten, soften lines, and improve skin texture, making the eyes appear less tired and wrinkled.  Go to someone reputable and honest, who is board-certified in these advanced procedures.  I wish you the best of luck, Dr. Emer.

Robert Kearney, MD, FACS · Answer

At 24 you are not a good age to overhaul anything.  Botox is great prevention and I would stop there. It is very difficult to tell in a smiling picure about your "hollowness".  At any rate you look like a young attractive woman, don't go over board

Mehryar (Ray) Taban, MD, FACS · Answer

Difficult to assess your lower eyelids, but in regards to your upper eyelids:1. You have upper lid ptosis (droopy) which elongates vertically the upper eyelids and pronounces any pre-existing hollows.2. You do have upper eyelid/brow hollowness, and benefit from either filler or fat injections. Filler do last a long time around the eyes, unlike other parts of the face. Fat is long-term but not all the fat injected takes.See an oculoplastic specialist for evaluation.

Michele S. Green, MD · Answer

The photo that you are provided shows you are beautiful.  Proper skin care, Retinol use, and sunscreen are all important to preserve the delicate skin around the eyes.  A small amount of Botox to the crow's feet and Belotero under eyes can all make your eyes look more to your ideal.  It is most important to find an experienced dermatologist who does a lot of facial injections for the best cosmetic results.

Curtis Wong, MD · Answer

As many others have said, I agree that from your photos, I can't really say you need anything.  Best to continue with sun protection and simple things like Retin A to keep your skin exfoliating and you should be good.  Now if you do have really deep set eyes, you can consider dermal fillers (temporary) or fat grafting (assuming you have some extra somewhere and are accepting of the risks) to remedy that.  But IMO, I think your eyes look great as they are.

Sean Freeman, MD · Answer

newleaseX2, I must be missing something in your photo. I son't see anything particularly that needs my attention. Certainly BOtox or an equivelent may be a good idea. Don't let anyone get the knives out! See my web site for further information. Good luck!

Darryl J. Blinski, MD · Answer

BOTOX for the crow's feet effect and YES a filler like Belotero Balance for the lower orbital wrinkles.///

Samer W. Cabbabe, MD · Answer

At your age, I would not recommend anything more than Botox.  I would consider some facial products and recommend avoiding sun exposure to help with these. Make sure you see a board - certified plastic surgeon.

Karen Stolman, MD · Answer

I would recommend Botox for the crow's feet and the little muscle roll under your eyes (some docs call it the banana or jelly roll).  I would suggest a hyaluronic acid filler to your tear trough groove which will help lessen the ridge near your nose.  You may also consider laser wrinkle resurfacing/tightening or radiofrequency treatment of your eye wrinkles as a compliment to the other treatments.

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