What is the Best Treatment for These Type of Undereye Lines? (photo)

I have been researching , trying to figure out what treatment would get the best results for my undereye wrinkles. Botox? Peel? Laser, if so which kind? Surgery ? All of the above? Thanks for your time.

Doctor Answers 3

Radiesse as Treatment For Undereye Lines

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It seems that wrinkles in your picture are visible when your face is at rest. Botox is recommended mostly for upper facial wrinkles such as crows feet, forehead wrinkles and vertical frown lines between the brows.

It relaxes the muscles so that they don’t contribute to wrinkles.

This form of treatment best addresses dynamic wrinkles which are visible when the face is moving. 

An option to consider for your case would be to smooth out the wrinkles. This may be done by adding volume to the loose skin under your eyes.  Radiesse might be an injection to consider since it is very versatile.

If you are interested, here is an example of a patient who was able to rejuvenate her undereye wrinkles using Radiesse. This was done in the same procedure as her cheek lift.


Redondo Beach Dermatologic Surgeon
4.6 out of 5 stars 33 reviews

Botox vs Laser for lower lid wrinkles

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I would try Botox first, that should get rid if the longer lines under your eyes.   If the crepiness of the skin is bothersome to you, a laser treatment with the Alma - Pixel would help.  For long term maintenance, nothing beats nightly application of Tretinoin cream.  Below is a link to a video of me using the Alma laser.  Hope this helps!

Marilyn Pelias, MD
New Orleans General Surgeon

What is the Best Treatment for Under Eye Lines?

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Crepey, lower eyelid skin can be improved, but in my opinion it can't be removed permanently. The recommended treatment plan would depend upon the patient's age, the degree of wrinkling in the lower eyelid skin and the degree of improvement the patient desires. Perhaps the easiest way to improve these lines would be as follows with the less invasive option first.


  • BOTOX injection on the side of the lid.
  • A topical Tripeptide, Stemcell product used twice per day to maintain the results


For the older patient with significant lower eyelid wrinkling, that is seeking a longer lasting improvement,  I recommend a more aggressive approach:

  • Laser Resurfacing of the lower lid and an aggressive skin care maintenance program including a Tri-Peptide Wrinkle Reducing Serum. In most cases this approach can improve the wrinkles of the lower lid by 40 to 70%.


For the younger patient with less eyelid wrinkling and desires a longer lasting result that BOTOX,  I would recommend a less aggressive approach. One should expect a 30 to 50% improvement with this approach.

  • Profractional Laser or Pellevé three times per year
  • Microlaser Peel once per year
  • Tri-Peptide Cell Activator/wrinkle-reducing serum twice daily

Since aging and permanent wrinkle-removal is non-avoidable, maintenance is the key to avoiding and reducing unwanted wrinkles.

Joseph Rucker, MD, FACS
Eau Claire Plastic Surgeon
4.7 out of 5 stars 21 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.