Best under eye treatment for hollows and wrinkles? Female, 35 years (Photo)

Hello, i have been doing research on restylane to recover volume under my eyes. I am also very interested in improving skin quality because it looks really wrinkled when i smile (picture below), what laser options do I have? I hv contacted some top rated places in Toronto and all seemed prepared to inject in the first appointment. Can i get laser after the fillers or should laser be done first? How can i ask for a more complete assessment?

Doctor Answers 10

Eyelid treatments

You are definitely a patient who needs to be assessed in person. Based on your photo, I'm not sure that filler is the solution for you. Botox in the muscle may be a better solution. Laser skin resurfacing will help with the fine lines and wrinkles as will a high quality skincare routine. Schedule a consultation with a board certified plastic surgeon in your area to discuss your best options.  
My best,
Dr. Sheila Nazarian
@drsheilanazarian on Instagram


Beverly Hills Plastic Surgeon
4.9 out of 5 stars 52 reviews

Smile lines in lower eyelids

It appears to me that the roll of the muscle under the eye is responsible for the fold you are seeing.
The best option for this would be a neuromodulator such as Botox performed in a careful manner.
I suggest seeing a specialist in your area for this.

I hope this was helpful.

Adam Scheiner, MD
Tampa Oculoplastic Surgeon
4.3 out of 5 stars 32 reviews

UNDER EYE TREATMENT FOR HOLLOWS AND WRINLKES

THANK YOU FOR YOUR QUESTION. I HAVE SOME
PATIENTS WHO PREFER TO HAVE AN APPOINTMENT WHERE THEY CAN BE EVAULATED AND INJECTED
IN THE SAME VISIT TO SAVE TIME.  HOWEVER YOU CAN SCHEDULE AN APPOINTMENT
FOR YOUR INDEPTH ASSESSMENT SO  THE TREATMENT OPTIONS CAN BE EXPLAINED TO
YOU IN DETAIL AND THEN SCHEDULE A TREATMENT APPOINTMENT TO HAVE THE ACTUAL
TREATMENT DONE. SKIN CARE AND CHEMICAL PEELS OR LASERS CAN IMPROVE THE SKIN QUALITY,
WHILE FILLERS CAN ADD VOLUME TO THE UNDER EYE AREA TO RESTORE THE NORMAL
CONTOURS. BOTOX CAN RELAX THE FACIAL MUSCLES THAT CREATE FINE LINES AND
WRINKLES AROUND THE EYES. BOTOX AND FILLERS CAN BE DONE AT THE SAME TIME BUT
TYPICALLY LASER AND FILLERS SHOULD BE SCHEDULED AT LEAST 2-6 WEEKS APART.  GOOD LUCK WITH YOUR CHOICE. 

Camille Cash, MD
Houston Plastic Surgeon
5.0 out of 5 stars 29 reviews

Lower eyelid issues

Thank you for the questions. The photos do not demonstrate hollowing. They do show prominent lower eyelid muscles when you smile. The easiest way to manage this is with a minimal amount of Botox injected into the muscle of the eyelid. The other treatment methods might be attempted if the Notix is not effective. Good luck.

Under-eye wrinkles

Filler (hyaluronic gel such as Restylane) or microfat grafting can help to reflate under-eye hollowing which may reduce wrinkles caused by loss of fat with aging.  Usually this also requires filling of the upper cheek.  Fractional laser aids in skin texture and it reverses sun damage.

These procedures can be done together, or separately in either order.  Finally, a good topical skin regimen will help to maintain results and prevent future sun damage and skin aging.

Small droplets of Botox or Dysport can also soften the dynamic creases that form under your eyes as a result of smiling. 

Brett S. Kotlus, MD, MS
New York Oculoplastic Surgeon
5.0 out of 5 stars 42 reviews

Under Eye Fillers -- Use Cannulas and Go Conservative

Fillers combined with lasers give great results here.  Microneedling can ehnahce the results too.  I like belotero or restylane silk.  Go slow in this area.  Best, Dr. Emer.

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.9 out of 5 stars 168 reviews

Treatment of eyelids #laser #blepharoplasty #fillers #BOTOX

Dear Julianne2015

Thank you for your question and photos! There are many options for treating the area around the eyes and eyelids- fillers, botox, laser, Platelet Rich Plasma, and surgery/microfat grafting.
For best assessment - you should have an in person consultation.  From your photos- the lines appear when you are smiling- these are tougher to treat, beware that most procedures will not stop these without negative secondary effects.

With Warm Regards
Trevor M Born MD

Trevor M. Born, MD
Toronto Plastic Surgeon
4.9 out of 5 stars 107 reviews

Smile lines under eyes

Thank you for asking about your lower lids.

  • Botox into the lines under the eyes is effective and inexpensive for your wrinnkles.
  • I do not like the laser for the lower lids - it thins the skin.
  • A skin care program based on tretinoin (retin A) is the basis of all good skin care.
  • A phenol peel (in my hands) is better than laser.
  • Filler is temporary and under the eyes, often lumpy and has real risks.
  • I would consider having Botox, skin care and considering surgery.
Always see a Board Certified Plastic Surgeon.
Hope you find this information helpful. Best wishes.

Treatment for Under Eye Wrinkles and Hollows

The dark circles under your eyes caused by depressions in the area can be permanently corrected with surgery or temporarily camouflaged with fillers. Surgery would require a fat-repositioning lower lid blepharoplasty. In this surgical procedure, fat from the eye area is moved into the tear trough depression filling the depression.

There are great non-surgical option to fill in under eye depressions and hollowness. Using dermal fillers, a liquid eyelift can be performed. Dermal filler such as Restylane would be placed in the cheek and tear trough to hide the depression or bag underneath your eye.

Many times patients will try the non-surgical option first to see if they are happy with the result. If they do not get the results that are seeking, they can still undergo surgery. Other patients want a permanent solution and choose to undergo surgery.
 
At times, patients will have a darkening of the skin in this region. This staining of the skin can be difficult to treat and will not improve with either a liquid eyelift or a lower blepharoplasty.

To improve the quality of your skin underneath the eyes, I would suggest a good skin care regimen and either a laser treatment or a chemical peel. There are variety of peels and lasers that will work effectively in this area. For this reason the most important decision is to ensure you choose a good provider.

Each of these choices are viable options. I would carefully review the pros and cons of each procedure and decided what would be best for you.

Best under eye treatment for hollows and wrinkles? Female, 35 years

Without examining you I cant be entirely sure but it appears as though your "wrinkles" are related to overactivity of the orbicularis muscle of the lower lid as they don't really seem to be present at rest. Resurfacing with a LASER or other modalities is good for very fine wrinkles, which I don't see in the photos and are unlikely to be present at 35 years of age. To correct the dynamic wrinkling I would consider a small Botox injection into the lower lid combined with a hyaluronic acid filler for the hollowing. The only way to know for sure what will work is to book a consultation with a board-certified plastic surgeon near you. Best of luck! 

Mathew A. Plant, MD, FRCSC
Toronto Plastic Surgeon
5.0 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.