Best cosmetic procedure for under eye wrinkles? (Photo)

What is best cosmetic procedure for wrinkles under eye area? Like crows feet but under the eye...crinkly type skin? Want to look younger! I am almost 36 have had Botox so far but want something for directly under the eye

Doctor Answers 5

Treatments for under eye concerns

Hello!  Under eye wrinkles are a very common concern.  They are also one of the more difficult areas of the face to treat noninvasively.  The reason for this is simple: Generally speaking, there are 3 things which cause the aging process of the upper face.  

(1) muscle contraction, primarily in the upper face, can cause expression lines to be come etched into the skin.  

(2) volume loss along the cheek bones can lead to hollowing under the eyes, and lines of the lower face.  

(3)   The skin itself becomes weak and  stretchy with time due to loss of collagen.  Underneath the eye all 3 of these things come together to create the perfect storm.  Therefore, non invasive treatment for under eye wrinkles can be complicated.

In my experience, the best results come when you address all 3 of these problems one at a time.  Botox can be used directly under the eye (you have said you have had Botox before, but did not say if it had been directly under the eye, or around the crows feet).  It will help some, approximately 10-15%, but do not expect a miraculous change from it as the muscular contribution to these lines is a relatively small.  Filler can also be used, especially around the outside edge of the eye, and by lifting the skin, can help "fill out" some of these lines as well.  However, because you cannot place filler above the bone that surrounds the eye socket, there is a limit to how much benefit you can get from filler in that area.  The third thing you can do is to stimulate the skin to grow more collagen, so that has the ability to stand up to gravity better, which will reduce those lines.  Generally speaking, there are many treatments which increase College in the skin, but they have one thing in common.  Skin can regrow collagen, but only when it thinks that it has been wounded.  Therefore, all collagen increasing treatments are based on the concept of the controlled wound.  You do something to the skin, create some small amount of damage, and the skin responds by growing more collagen.  Lasers use heat to create this controlled wound, peels use acids, and microneedling uses physical puncture, however, they are all "getting at" the same healing response.  

For under eye line such as yours, I generally recommend  a series of collagen building treatments such as microneedling, which can go all the way to the lash line, followed by a small amount of Botox, and filler.  This can have a wonderful results, but does require time, and commitment to the treatment course.

Dark Circles, Eyelid Wrinkles/Bags Treatment -- Restylane or Belotero with Cannulas, Clear+Brilliant, Eclipse Micropen, Viva

I suggest a combination approach with lasers, fillers,skin care and microneedling/PRP however surgery is always an option. Please seek an expert for a consultation. Best, Dr. Emer.

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.9 out of 5 stars 165 reviews

Under eye wrinkles

Thank you for your question. Under eye wrinkles/laxity can be difficult to treat and we often treat that area with a combination of modalities. First of all, daily sunscreen and moisturizer is very important. There are different eye creams on the market that help prevent progression of these lines (TNS serum, Revision DEJ eye cream, Sente intensive eye therapy). Then we move onto Botox in combination with either laser resurfacing or microneedling. If you have volume loss in the area, then filler is used. I recommend consultation with a board certified dermatologist to determine which treatments are best for you.

Take care,
Dr. Tremaine 

Anne Marie Tremaine, MD
Naples Dermatologic Surgeon

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Combination treatments

The delicate eye ares is hard to treat and combination treatments work best. I don't see a lot of volume loss in your tear troughs to be replaced with filler, but botox or dysport are always the first step. If this does not give you enough improvement, based on available down time you are willing to accept, many differ treatment options are available. if you can't afford any down time, radiofrequency treatments such as pelleve, exillis and Infini can achieve great improvement in 3-4 session s wirh zero down time. Slightly better result can be created with fractional Resurfacing lasers (2-3 days) also with a series of 3-4 treatments. Or you can pretty much wipe out all the wrinkles with an ablative erbium laser, in a single treatment, with 2 weeks of down time and some pinkness around the eyes for about a month. Best of luck!

Neda Vanden Bosch, MD
West Palm Beach Physician
5.0 out of 5 stars 9 reviews

Under eye wrinkles

Combination treatment with Botox and fillers can accomplish a lot around the eyes. The lighting in your photo does not allow for a complete evaluation but I would discuss injectables with an expert physician. 

Resurfacing lasers, peels, and microneedling are also helpful with fine lines and wrinkles. Finally, sunscreen, retinoid, and good eye cream such as TNS Eye Repair by SkinMedica will also benefit you. 

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.