At 37 I was considering an undereye lift but are there other options? (photos)

Hi, Im wondering the best course of action for my under eye area. I want to remedy the situation when i smile, dark hallows and wrinkles. An overall improvement to the area is what im hoping for.

Doctor Answers 10

Options for under eye area

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

There are non surgical options that are available for you to consider.  A combination of treatments should help you see a noticeable improvement.  You can consider Botox or Dysport for the "crows feet" area.  This is a simple treatment done by injection and will last approximately 3 months.  You also may consider fillers for under the eye to give a smoother, better contour.  Finally skin treatments such as lasers, chemical peels, and microneedling (Skin Pen) will improve the texture and quality of the skin.  Visit with a board certified plastic surgeon in your area to learn more.

Options for undereye problems

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

I do not recommend surgery at your age and with the relatively minimal degree of deformity. For dynamic wrinkles consider Botox, Dysport or Xeomin. For the hollowed and dark circles consider monophasic HA fillers such as Belotero or fat transfer to blend the eyelid with the cheek contour. Fractional CO2 laser or a chemical peel, such as Jessner's/ 35%TCA or 88% phenol is a great way to tighten crepey skin and improve fine wrinkling. Consult a board certified specialist in your area.

More than one treatment for under eye area

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

To improve the appearance of your lower lid, there is more than one treatment option because there is more than one cause making your under eye appear tired.

For the smile lines (crow's feet), treatment with Botox or Dysport would be most effective.

The lower lid bag may be treated surgically with a lower lid blepharoplasty to reduce the "puff" beneath the eye.

Non-surgically, the cheek may be treated with filler. As you age, you begin to lose facial fat. When facial fat is lost in the cheek, your lower lid loses its support and lengthens, causing a more tired, worn appearance. Treating the cheek gives lift to the overall facial structure and support back to this area, shortening the distance between your lower eyelashes and the top of your cheek. This gives a more refreshed appearance and reduces much of the shadow cast on the lower lid. This, however, would not remove any of the fat pocket of your lower lid. Only surgery can do that.

Deborah Sherman, MD
Nashville Oculoplastic Surgeon

You might also like...

Options for under eye rejuvenation

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Based on the photos provided, the best treatment options for you would be non-surgical.  Chemical peels or laser skin resurfacing can be used to improve the fine wrinkles in the lower eyelids.  The lateral skin rhytids, or crows feet, can be addressed nicely with toxins, such as Botox.  Conservative use of dermal fillers in the lower eyelids can be used to improve the overall contour.  Thank you for your question and best of luck.  

Paul Nazemi, MD
Newport Beach Oculoplastic Surgeon

Eye Rejuvenation Treatments

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Thank you for your question. There are a variety of non surgical eye rejuvenation treatments available. For crow's feet Botox can be an efficacious option. For under eye rejuvenation injectable fillers, laser rejuvenation, and peels can be effective. I would recommend an in person consultation to determine your candidacy. Best wishes. 

Under Eye Rejuvenation with fillers, lasers, microneedling/prp

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

There are alot of great options for this area. Fillers, lasers, and microneedling/PRP can improve under eye hollows. My patients try to get non surgical treatments to avoid surgery. We use PRP and stem cells there often. I suggest consulting with an expert to develop a treatment plan best suited for your short and long term goals. Best, Dr. Emer.

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.8 out of 5 stars 203 reviews

Young with wrinkles

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

This is a common question so I will give you how things are done in our practice. 

For smile lines (around the eyes) and forehead wrinkles, at your age, strategically placed botox. For the dark circles you really need a good facial analysis and physical exam to determine the cause as different causes lead to different treatments.

For example, in  my hands, lax skin =  laser resurfacing

Orbital fat prolapse =  transconjunctival blepharoplasty with fat repositioning, possibly autofat transfer to the face vs. synthetic filler

Deep nasojugular groove =  possible mid face lift

Festoons =  classic blepharoplasty with orbicularis work and possible skin pinch

Hope this helps.

Best of luck,


Benjamin Caughlin, MD
Chicago Facial Plastic Surgeon
5.0 out of 5 stars 12 reviews

Lower eyelid concerns

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Based on the pictures provided it seems that injectable treatments could be an alternative solution to surgery.  If your concern are the wrinkles that appear when you express yourself (ie: smiling) then Botox would be the best treatment.  If your concern are wrinkles at baseline, or without expression, then Fraxel would be a good treatment choice.  Botox and Fraxel both have a high safety-profile and would be perfectly acceptable forms of treatments for your concerns.

Seek treatment by an experienced board-certified facial plastic surgeon, general plastic surgeon, or dermatologist.

There is no remedy for forming that smile wrinkle without destroying the appearance of the eyelids.

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

You do not need lower eyelid surgery.  Your lower eyelid is beautiful and lower eyelid surgery will not make it more beautiful but it will harm your lower eyelid by making it hollow, placing a scar under your eyelashes, paralyzing the lower eyelid muscles.  This will make you look older and not better.  Instead of surgery, I recommend under eye fillers.  Less is more and look for the very most experienced injector you can find for this.  That is easier said than done.  I do see folks who fly in from your community so I know finding the right doctor is challenging.

Kenneth D. Steinsapir, MD
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 26 reviews

Nonsurgical lower eyelid lift

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Most of your concerns can be improved with injectable fillers. The smiling wrinkles may also require botox. Check out the video and webpage for details!

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.