Wrinkles & Under Eye Bags

Dr. Melanie Palm is a nationally recognized dermatologist and cosmetic surgeon specializing in eye wrinkle treatment and nonsurgical rejuvenation around the eye. Her offices are located in Solana Beach, CA just north of San Diego. Dr. Palm lectures nationally at the American Academy of Dermatology, the American Society for Dermatologic Society, the American Society for Lasers in Medicine and Surgery as an invited speaker on rejuvenation around the eye. She offers many effective injectable filler and laser treatment options.

Wrinkles in the Eye Region

Wrinkles around the eyes are often referred to as “crow’s feet” or lateral canthal lines in the medical world. They are caused by the following reasons:

  • Overactive muscles: a large O-shaped muscle around the eye called the orbicularis oris allows the eyes to close. Over decades, this repeated movement causes eye crinkles and wrinkles around the eye
  • Sleeping: side sleeping can lead to creases along the brow, eyelid, and side of the face
  • Loss of facial volume: loss of fat and soft tissue around the eye leads to decrease support in the area around the eye. Less support allows wrinkles to form more easily.
  • Sun damage and environmental exposure: UV and exposure to the elements weather and age the face, contributing to textural changes including wrinkles around the eyes.

Treatment of Eye Wrinkles

Treatment of crow’s feet and wrinkles around the eyes depend on the underlying cause and individual patient characteristics. A step-wise approach to treatment is favored and may include one or some of the following:

  • Eye cream: topically eye creams with effective active ingredients are an important part of a daily topical skin care routine to rejuvenate the eye region
  • Botox: Botox, Dysport, and Xeomin are all FDA-approved botulinum toxins that relax overactive muscles and improve wrinkles related to overly expressive facial animation. Botox is FDA-approved for crow’s feet treatment.
  • Laser treatment (nonsurgical blepharoplasty):
    • CO2 laser resurfacing: This ablative laser builds collagens, tightens skin and improves wrinkles in the eye region. Due to its ability to resurface and tighten the skin, it is sometimes considered a nonsurgical option for treating redundant upper and lower eyelid skin.
  • Skin Tightening: these procedures improve skin crepiness and the overall texture and fine wrinkles around the eyes.
    • Protégé Elite: this no-downtime, no pain procedure is a radiofrequency device that over a series of treatments tightens under eye skin and improves crepey wrinkles around the eye.
    • Ultherapy: this ultrasound-based device is used around the eyes to tighten, lift, and improve texture of the skin.
  • Injectable fillers: these provide support to the area to improve contours and light reflectance in the under eye circle region.
    • Restylane and Restylane Refyne: these hyaluronic acid fillers restore volume appropriately do not attract excess water and swelling to the eye region like other fillers
    • Belotero: this hyaluronic acid filler can be placed superficially in the skin to improve fine wrinkles and reduce discoloration in the under eye region. Belotero can also be used to soften the appearance of the tear trough region.
    • Fat: One’s own fat can be grafted through autologous fat transfer to rejuvenate the entire eye region and to improve the tear trough region.

Under Eye Bags

Under Eye Bags refer to excess volume below the lower eyelash line. This occurs in some individuals and is often due to hereditary influences, although allergies and other conditions can cause or exaggerate under eye fullness. While a surgical procedure called a blepharoplasty is appropriate for some patients with severe under eye bags, noninvasive and minimally invasive treatments may help to improve the under eye region.

Treatment of Under Eye Bags

Nonsurgical options for mild to moderate unwanted under eye bags include the following approaches:

  • Skin Tightening: these procedures improve skin crepiness and texture in addition to promoting skin firmness around the eyes.
    • Protégé Elite: this no-downtime, no pain procedure is a radiofrequency device that over a series of treatments tightens under eye skin and improves crepey wrinkles around the eye.
    • Ultherapy: this ultrasound-based device is used around the eyes to tighten, lift, and improve texture of the skin.
    • CO2 laser resurfacing: This ablative laser builds collagens, tightens skin and improves wrinkles and skin laxity in the eye region. It helps to tighten mild under eye bags sometimes referred to as “festoons.”
  • Injectable fillers: these provide support to the area to improve contours. Placed correctly in the right patient, injectable fillers can camouflage and minimize the appearance of under eye bags.
    • Restylane and Restylane Refyne: these hyaluronic acid fillers restore volume appropriately do not attract excess water and swelling to the eye region like other fillers.
    • Belotero: this hyaluronic acid filler can be placed superficially in the skin to improve fine wrinkles and reduce discoloration in the under eye region. Belotero can also be used to soften the appearance of the tear trough region.
    • Fat: One’s own fat can be grafted through autologous fat transfer to rejuvenate the entire eye region and to improve the tear trough region.

A combination approach is sometimes ideal to improve and minimize the appearance of under eye bags and crow’s feet. Non-invasive and minimally invasive techniques are used at Art of Skin MD in addition to topical skin care regimens to achieve the aesthetic goals of our patients in regards to dark under wrinkles around the eye.

If you are interested in learning more about under eye bag treatment, or would like to set up a consultation, call Dr. Melanie Palm at 858.792.SKIN (7546) to schedule your appointment.