Under Eye Lines

A woman seeks advice about how to rid herself of under eye lines

Beauty Queen

Under Eye Creases

Dear Beauty Queen: I am really curious about injectables and non-surgical fixes for the fine lines UNDER my eyes. I have heard that Botox is really better above the eyes, and Juvéderm is supposed to be great for between the brows and those lines that go from the sides of the mouth – but my problem is these pesky under eye wrinkles. I’m leery of lasers because of scarring and I don’t want to try Thermage because we all need a little fat in our faces as we age.

I have noticed that lots of celebrities seem to have some kind of a ‘fat pad’ that has suddenly appeared under their eyes – it smoothes out the wrinkles, but is does look kind of artificial. Is there a peel or other fix you’d recommend? Thanks for any help you can give me with this!

Beauty Queen: Wow, it certainly seems like you’ve done your homework! Although I commend you for educating yourself, let me – and Boca Raton, Florida oculoplastic surgeon Steven Fagien, MD – help you get a few of your facts straight.

First off, Botox is great for dynamic wrinkles, which are the ones caused by facial expressions. It works wonders for crow’s feet, horizontal lines on the forehead, the vertical lines between the brows, and even around the mouth in experienced hands. (By experienced hands I mean a dermatologist or plastic surgeon that has extensive experience using Botox in off-label areas – which is anything other than the vertical lines between the brows.)

And Thermage doesn’t target fat. The company claims that it can tighten saggy, wrinkly skin, but many patients and doctors don’t feel the subtle results are worth the money – the choice is yours. Yes, Juvéderm is fabulous for plumping up the nasolabial folds on the sides of the mouth, and while it can help fill depressions under the eyes, it’s not always the best bet for treating wrinkles under the eyes. According to Dr. Fagien, this ‘fat pad’ you’re seeing on a lot of celebrities is likely injectable hyaluronic acid (such as Juvéderm, Restylane or Perlane), and it looks artificial because you have to inject a lot of it to plump up the area enough to eliminate those wrinkles.

Dr. Fagien says, “Hyaluronic acid fillers can help in the right person. The problem is that patient presentations are so varied, the techniques used by injectors are all so different, and all hyaluronic acid products are not the same. Wrinkles are usually a skin issue and trying to fix them in an indirect way (such as plumping up the area with fillers) is usually less effective than treating the skin directly with energy-based devices or peels.”


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