What is the best treatment for fine lines under the eyes? (photo)

Doctor's Answer

I understand you have a few concerns. I shall answer your concern about fine lines first. Firstly, allow me to clarify a few misconceptions you may have. Fine lines on the under-eye region are usually brought upon by:

1. UV damage caused by sun exposure

2. Loss of intrinsic collagen through aging

3. Static wrinkling of the skin as a result of repeated dynamic wrinkle formation

From the picture, you do have a significant line at the under-eye regions for both eyes. However, strictly speaking, yours are not fine lines, as they do not have their origins from the superficial part of the skin. Your lines are in fact brought upon by the natural muscle anatomy around your eyes. I have attached a photo depicting fine lines at under eye regions. Do appreciate the subtle difference in appearance from yours.

In your case, the lines are not due to your skin losing collagen, but more to do with your pre-tarsal muscle being hyperactive and strong. Over the years, the size of the muscle have grown into a sizeable mass, with a line beneath this ‘mass’, which many individuals would have wrongly describe this appearance as an ‘eyebag’. Can this line be treated? Definitely yes. This line is actually best addressed with small amounts of Botox placed at the correct depth to relax the pretarsal muscle. Doctors who attempt to do this will have to ensure good residual muscle strength, and patient may need additional fillers to improve the general under-eye appearance.

As for dark eye rings, they are best treated with combination therapies. This is because dark eye rings can be caused by a multitude of factors:

1. Volume loss of the cheeks resulting in hollowing of the under-eye regions

2. Pigmentation formation on skin surface

3. Venous congestion from chronic sinusitis, lack of sleep, stress, or other medical conditions

As you can see, these factors cannot be simply addressed by a single therapy alone. In your case, I do see the beginning of dark eye ring formation. I would recommend:

1. Dermal fillers

  • for support of underlying tissues around the eyes and revolumization of cheek areas if needed
  • increasing skin elasticity and hydration

if you need further rejuvenation, I would go on to:

2. Eye rejuvenation laser

  • improvement of venous congestion under the skin surface
  • brightening and reduction of pigment on the skin resurfacing
  • mild resurfacing for texture refinement

Hope you find the above helpful.

Finally, do consult your dermatologist or aesthetic doctor to explore different treatment options available.

Take care and all the best!

Best regards,

Dr Heng Wee Soon

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