What is the best non-surgical treatment for my crepey under-eye area with thin skin? (photos)

Hello, and thank you for your question!
I believe that you would be a great candidate for a procedure that I call Aesthetic Facial Balancing. A large part of my practice is using this procedure.  What this means is evaluating a patients face and bringing the features into harmony by making adjustments with either hyaluronic acid or fat.  The most important component of a fillers treatment is the practitioner administering it. I take filler and balance all features in your face from top to bottom to make them work together to 'unlock' your beauty. I would create the contours, shapes and light reflexes of youth and beauty by restoring volume in the proper places. The result is the disappearance of the bags and hollows and a refreshed look under the eyes. If there is significant pigment in the lower lid skin, I can also use BBL, (broadband light), a gentle pulsed light intervention to eradicate the pigment. The Aesthetic Facial Balancing procedure is not just a filler intervention augmenting the cheeks and lips, but as in overall, non surgical way to shape the face in a different way to create natural appearing results that will last for years. 
I hope this helps!
Wishing you beautiful results,Dr. Rian Maercks M.D.

Fractional CO2 laser is an excellent tool for skin rejuvenation in our center in Santa Monica. We use the fractional multi-depth ablative approach to help resurface the skin, recontour acne scars, improve incisional plastic surgery scars, and reduce surface irregularities from skin tone to dark pigmentation. Our approach utilizes a multi-depth approach that targets melanocytes in the epidermis and collagen fibroblasts in the dermis. This approach can be combined with a TCA Peel in a process known as a sapphire peel. Fractional laser is excellent for acne scars and contour scars in the skin. Patients are advised to undergo skin protocols with Melarase creams before and after treatment to help reduce pigmentation. Melarase AM, Melarase PM, and Melapads can seriously improve surface sun damage and UV related pigmentation. After the laser, we expect redness for a few weeks as the skin improves. PRP and Hydrafacial enzyme facials can further improve skin quality after fractional co2.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Dear   Dustwhirl,
As we age our skin changes in ways we often wish it wouldn’t. Brown spots and wrinkles form, making our skin look old, tired and less healthy. What causes skin aging and wrinkles, and how can we prevent them?
The number one cause of skin aging and wrinkles is ultraviolet (UV) light exposure from the sun. Every time our skin is exposed to the sun, ultraviolet rays cause a small bit of damage to our skin. UV rays from the sun are present from sun up to sun down and penetrate clouds and car windows. The most damaging UV ray is UVA. We think of the “A” for skin aging. These UVA rays fracture the elastic and collagen fibers in our skin causing the skin to wrinkle and droop. They also bind together parts of our DNA in our skin which can lead to skin cancers.
The key to preventing this damage is to wear broad spectrum sunscreen which blocks UVA and UVB rays on a daily basis on all sun exposed parts of the body. My favorite forms of broad spectrum sunblock are mechanical or physical blocks containing Zinc Oxide and Titanium Dioxide.
If sun damage has already occurred, certain medical products like Retin-A and Hydroquinones have been shown to reverse some of the damage caused by ultraviolet sun exposure. A deeper level of reversal can be achieved with laser and light sources. Broad Based Light treatments have been shown to cause the skin to revert back to a younger genetic state. My deep laser RESET procedure can dramatically remove sun damage and certain early skin cancers and restart a person’s skin back to a younger, healthier and more attractive state. To learn more about this topic, take a look at the blog I wrote called What You Need to Know About Aging of the Skin.
I hope this was helpful.

Fillers like Belotero, Volbella, and Restylane Silk are good for improving under the eyes, but keep in mind that a combination approach will give the most improvement. My patients try to get non-surgical treatments to avoid surgery, so we use fillers, lasers, microneedling/PRP and stem cells. I suggest consulting with an expert to develop a treatment plan best suited for you. Best, Dr. Emer

In order to soften the lines, the best approach would involve skin resurfacing to induce collagen formation, so treatments such as microneedling or laser treatment (such a CO2). If you were planning to have lower eyelid surgery, you could have some of the skin removed with a pinch technique but I would still recommend skin resurfacing to improve the skin quality and tone.

A multi-modl approach is going to work best. Skincare, microneedling etc. There is a new injectable that stimulates skin formation called Sunekos that is worth a look. will help thicken up and improve the skin condition.

There are options to consider such as microneedling, PRP and lasers that can help improve skin tone and texture.  You may want to consider a less dense filler if you are nervous about thin skin.  See an experienced injector near you to learn more.  I encourage you to use medical grade skin care products and sunscreen every day.

The skin under the eyes is always thin and due to the blood vessels under there, you can see dark circles.  The cure would be to thicken this skin somehow.  I would start with excellent medical grade skin care eye cream, like Hydrafirm from ZO.  Then I would microneedle that area multiple times.  If you add platelets (like a Vampire Facial would), you will get even better results.  But it will take a series of treatments and time so be patient.  Good luck.