Smooth out wrinkles under eyes and fix divot - Botox, fillers, laser or surgery? (photo)

Question

I have been getting botox and filler for years but under my eyes are an area of concern. I got some botox lower under eye (I think) to see if that'd smooth out the wrinkle but it made it look worse with now a divot/concave under my eyes. What route should I go to address this trouble area and smooth it out: more botox, fillers, skin resurface, surgery, etc? Thank you.

Anna Chacon, MD, FAAD · Answer

When addressing wrinkles and divots under the eyes, it's important to choose the right treatment based on the specific concerns and your skin's characteristics. Here are some options to consider, along with their potential benefits:

Fillers: Hyaluronic acid fillers can help fill in the hollows or divots under the eyes, providing volume and reducing the appearance of wrinkles. However, it's crucial to have this done by an experienced injector to avoid overfilling or uneven results.

Botox: While Botox can be effective for dynamic wrinkles caused by muscle movements, it may not be suitable for static wrinkles or volume loss under the eyes. If Botox has previously worsened the appearance, it might not be the ideal solution for this area.

Laser Resurfacing: Laser treatments, such as fractional laser resurfacing, can improve skin texture and stimulate collagen production, which may help reduce fine lines and improve skin elasticity around the eyes.

Microneedling: This treatment can also stimulate collagen production, helping to improve the overall texture and firmness of the skin under the eyes.

Surgery (Blepharoplasty): In cases of significant under-eye bags or excess skin, a surgical approach like blepharoplasty might be considered. This procedure can remove excess skin and fat, providing a more permanent solution to under-eye concerns.

Consultation with a Specialist: It's essential to consult with a qualified dermatologist or plastic surgeon who can assess your specific needs and recommend the most appropriate treatment plan. They can evaluate factors such as skin type, underlying structures, and previous treatments to tailor a solution that best addresses your concerns.

Each of these options has its own set of benefits and considerations, so a personalized consultation will help determine the most effective approach for your individual situation.

Camille Cash, MD · Answer

You may want to consider Morpheus8.  This treatment combines RF technology with microneedling to improve overall skin tone and texture.  Typically three sessions are recommended for optimal results.  I've included a video I hope you find helpful.

Chris Atkinson, MD · Answer

I recommend you try prp injections and RF microneedling such as morpheus8. We have seen good results with both of these modalities combined.

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