- Best Results1-3 sessions
- Treatment Recovery0-9 days
- Procedure TimeVariable
- Skin SpecialistNurse, Davin Lim
- Duration of Results16 to 48+ months
- AnaestheticVariable
- Back to WorkVariable
- Cost$-$$$$
Eye Wrinkles
Eye wrinkles can be classified as dynamic or static. Dynamic wrinkles such as crow’s feet are exacerbated by movement. Static wrinkles are wrinkles at rest. I employ injectables, lasers, micro needling, chemical peels, energy devices & surgery to treat periocular wrinkles & laxity. Skin care with retinoids & alpha hydroxy acids can prevent eye wrinkles.
FactsFacts on Eye Wrinkles
- Crow’s feet are due to expressive muscle action
- Simple muscle relaxing injections can treat & prevent this type of wrinkling
- Sun damage causes break down of collagen
- This form of wrinkling presents as deep static wrinkles
- Lasers & peels are required to diminish static wrinkles
- Skin care can prevent & reduce all types of wrinkles
How to approach eye wrinkles?
Eye Wrinkles
The best treatments are aimed at looking at the entire cosmetic unit that is the orbit. This means the relationship between the eyes (& wrinkles) & the surrounding skin.
If you have wrinkles caused by muscle movement, simple muscle relaxing injections are best. Once muscle movements are reduced, your wrinkles will get less. It often takes 3-4 months.
If you have deep wrinkles secondary to sun damage, laser resurfacing or chemical peels are best. Most patients will also have an element of dynamic wrinkles, hence a wee bit of tox will help.
How can dermal fillers help reduce eye wrinkles?
Dermal fillers are invaluable for the under-eye area – if it is correctly performed. Fillers, as the name suggests, provide volume replacement. If you are hollow, you only have three choices to replace volume- fat, filler, or a dermal implant. Lasers, peels, HIFU & RF/Thermage cannot replace subdermal volume (in some cases they make it worse).
I use a variety of fillers ranging from calcium hydroxyl through to hyaluronic acid fillers of varying molecular weights.
What is the rule for dermal fillers under the eye?
HA fillers used strategically can be very effective. We have known for the past 6 years that fillers around the eyes can last for a very long time. Anecdotally I still have filler under my eyes from 2016! How I approach my patients is how I approached my own filler placement. I had only 0.15 ml of HA filler, aiming for a very slight, but noticeable correction. Over the next few years, the area took in more water, hence it looks better with time. This is how I fill the under-eye area.
Why does under eye filler cause swelling & what to do?
There are two main problems with fillers under the eyes, firstly they take in water over time, leading to swelling, bulging & overcorrection. This happens when your injector tries too hard to correct tear troughs & undereye wrinkles.
Secondly high-density HA fillers can lead to Tyndall; namely blueing of the skin due to superficial or migrating fillers. This is less important if you have darker skin, but very noticeable if you have light skin.
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What is a good anti-wrinkle eye cream?
What is the purpose of eye creams? If it is for wrinkles, you are best served with procedures such as lasers, peels, Tixel, dermal fillers & injectables. Eye creams are best for prevention of wrinkles, look for the following ingredients-
- Retinol; build collagen.
- Ascorbic acid: reduces dark circles, builds & preserves collagen & elastin
- Peptides; increase dermal matrix
- Hyaluronic acid; increases hydration, reducing wrinkle
- Caffeine, vitamin K; modifies blood vessels & circulation
What is Tixel for eyes?
This gentle non-laser treatment addresses wrinkles with little or no downtime. It uses super-heated titanium pins to provide thermomechanical energy. Tixel is best for mild to moderate undereye wrinkles. Treatments are well tolerated with very little or no downtime. 3-5 sessions are required. It is safe in all skin types.
Can chemical peels help?
Yes, however they must be performed with caution. If you have moderate to severe eye wrinkles, my agent of choice is Jessner TCA as a medium to deep peel. Downtime is over a week. In some cases, I combine this with CO2 laser resurfacing.
For mild wrinkles, you have the option of superficial peels including glycolic, lactic, mandelic & retinoic acid peels.
Do I use nano fat transfer around the eyes?
I occasionally employ fat transfer to correct large volume defects, especially in the cheeks. I do not like nanofat around the eyes because-
- The results are unpredictable & not replicable. I like certainty in my work.
- Collagen stimulating fillers (wash) provides better integration
- Lasers provide much better remodelling of skin compared to adipose stem cells
When is surgery indicated for eye wrinkles?
There are 3 main indications for surgical correction of eye wrinkles-
- Upper lid laxity: treatment is a blepharoplasty.
- Lower lid laxity, treatment is transconjunctival blepharoplasty+/- fat removal.
- Brow lift +/- lateral canthal pexy.
What can be done for dark circles?
In some cases, lots, in others minimal. Read the section on dark circles. If you have laxity, volume loss & eye wrinkles, a combination of laser & dermal fillers can do wonders. I prefer pico, nano lasers & Tixel for dark circles.
Do HIFU / Thermage & RF devices work for eye wrinkles?
It depends on the amount of laxity & your age. I do use Pelleve or Tempsure for eye wrinkles. HIFU off label can be effective for upper eyelid laxity. If you have very little sun damage & good dermal volume, non-surgical skin tightening can give good results.
So, what does an eye wrinkle treatment & prevention program look like?
The best methodology will depend on your age, laxity & clinical findings.
- Mild To Moderate Eye Wrinkles
Treat with: Tixel, muscle relaxants
Maintain with: Tixel, retinol & peptide creams
- Moderate to severe Eye Wrinkles
Treat with: Laser resurfacing or surgical methods
Maintain with: Tixel, dermal fillers, peptides, & vitamin C serums
Who to see for eye wrinkles?
For mild cases of under eye wrinkles, book an appointment with my clinical nurses. They will discuss effective methods to treat eye wrinkles & maintain with simple cost-effective procedures & skin care.
For complex cases & severe wrinkles, book an appointment with me. I use surgical & lasers to rejuvenate the eye area. I also perform more complex dermal fillers. I do not provide skin care assessments or advice but will refer you to my clinical team.
Davin’s Viewpoint on eye wrinkles
To do it well, you must look at the orbit as a unit that merges in with the temples & forehead above, and the cheeks below. It is the ‘C’ shaped area we are talking about. It is far more complex than injecting Tox or laser resurfacing eyelid skin.
In younger patients (late 30s and below), most can get away with simple muscle relaxing injections. In some cases, dermal fillers can either correct or enhance age or genetic deficiencies. Simple no downtime procedures like Tixel can be effective.
In middle-aged patients, I tend to use less neurotoxin (as I do believe the eye muscle can help lift the cheek below). I tend to use more dermal fillers & address skin quality. The latter can be treated with superficial fractional lasers, including LaseMD, Fraxel, Frax, & even CO2.
For older patients, the solution is not a ‘one shot’ treatment. Medium depth peels are useful, ablative resurfacing can give good results. If wrinkling is severe, surgery is an option. Displacing wrinkles with dermal fillers address both volume & static wrinkling.
