Wrinkles under eyes. Is it best to use Microneedling or filler? (photo)

Question

Hi. I am 38 and just had my second treatment of MN, I am having MN for my dark spots. I also wanted to see if it helps with wrinkles under eyes. However I still see no improvement on the wrinkles. The esthetician doesn't want to get to close to under the eye area even if I ask her to so she can microneedle directly where the wrinkles are. How close can you get under the eye and how many treatments do you need remove wrinkles? Maybe MN isn't the best treatment and fillers is what I need?

Raffy Karamanoukian, MD, FACS · Answer

Morpheus 8 is a non-invasive skin and soft tissue tightening treatment that is consistently amazing in our patients. We use the Morpheus to exact fractional induced RF into the skin or tissue in order to tighten collagen and stimulate contraction of the tissue. For acne scars, it is quite useful to build collagen in patients who have atrophic scars but is not very productive for ice-pick scars which require TCA Cross. For tissue tightening, Morpheus is ideal for the face and neck and we often combine it with CO2 laser or Ultherapy to further enhance results. Chemical peels and skin resurfacing should be done at least 5 to 7 days after, but can be performed earlier, depending on treatment severity. Avoid exfoliating skin treatments before Morpheus and expect a period of 2-4 weeks for skin contraction to set in.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best, 
Dr. Karamanoukian 
Realself100 Surgeon

Jason Emer, MD · Answer

A combination approach will give the most improvement. Fillers, lasers, and microneedling/PRP can improve under the eyes. 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

Bernard Lalonde, MD · Answer

I would have to agree with other physicians responding to this question that usually a combination treatment approach is best for under the eyes. If you are concerned about "hollowness" or loss of fat/volume under the eyes, filler would most likely be the best option - this is an easy and fairly pain - free procedure with little to no downtime and the results last around 12 months. For fine lines/wrinkles, we often use micro-needling and PRP to get the best results. With the Eclipse MicroPen, we are able to go extremely close to the lash line to target fine lines. Often, we are treating our patients with both filler and micro-needling devices to treat both issues and get the best results.

Aurora DeJuliis, MD · Answer

You need a formal evaluation with a physician in order to make a decision on the best treatment for you. Microneedling using PRP works well at stimulating collagen. You mention an aesthetician is doing the treatment. The most effective microneedling is usually performed by a physician. A light filler such as Belotero can also help in minimizing your lines.
Good luck.

Lani Warren, MD · Answer

Hello,
Without seeing you in person it is hard to determine what is best for you.  I have been doing microneedling for 5 years and have been able to get pretty close to the eyes.   However there are different treatments if you don't want to do any injectables fine lines/dark circles.  I would recommend Fraxel, Chemical Peel and or Pelelleve.  all that I have seen a good result with.  I would consult with a couple offices in your area to get their recommendation.

Best wishes to you,

Daniel Straka, MD - Account Suspended · Answer

In my opinion there are no perfect options for the fine lines and wrinkles you have shown in your photograph.  Some doctors will inject superficial filler in the skin of the eyelid in micro droplets to try and plump it and reduce wrinkles. While this does work in some people there are risks of the filler being visible and giving an unnatural look.  Of the two options you mentioned microneedling would be what I would recommend. However, I believe neither of the options you listed (microneedling or filler) are the best treatment for those lines.  No matter what, complete removal of small lines of the lower eyelids is very difficult to safely do. When you get too aggressive in this area it can lead to problems with he position of the eyelid down the road. My favorite treatment for this area is laser resurfacing. I perform either full field ablative laser or fractional laser (sometimes a combo of both) all depending on the skin thickness, turgor, and a few other measures.  Other things that can help are topical eye creams with hyaluronic acid to hydrate the skin and reduce wrinkles. Although this is not permanent it can temporarily improve them.  Hope this helps.

Wrinkles under eyes. Is it best to use Microneedling or filler? (photo)

Answers (6)

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