There are many treatment options for the area under the eyes, ranging from chemical peels of varying strengths to Botox, fillers, and surgery. The best treatment really depends on the individual patient’s face. Fine lines can be improved with Botox or Dysport. I don’t prefer to use fillers for fine lines in this area, but I use fillers frequently for “dark circles,” such as Restylane or Belotero.
Chemical peels and resurfacing lasers are also great in this area, giving a smoothing effect while at the same time tightening the skin. These can easily be done together with a lower eyelid lift (blepharoplasty) for the removal of lower eyelid bulges, also known as “bags.” For someone who has quite a bit of lower eyelid skin excess, surgical removal via an incision on the outside of the lower lid is the most powerful way to smooth the skin, but this must be done with care in order to prevent pulling down on the lower lid creating a sad or drawn appearance.