Medically reviewed by Dr Sin Yong · Last reviewed · 12 min read · Doctor-performed, never delegated · Jump to questions
Dr Sin Yong · MBBS (NUS) · MRCS (Edin) · MSc Aesthetic Medicine with Distinction (Queen Mary, London) · MSc Practical Dermatology (Cardiff) · International KOL
The skin under your eyes is the thinnest on the face — which is why it wrinkles first, why it shows everything, and why the reflex answer, filler, so often makes crepey skin look worse. Lines here divide into three kinds with three different answers. The assessment tells you which yours are before anything is injected.
Under-eye lines fall into three kinds: dynamic lines made by the orbicularis muscle, static lines etched into the collagen, and crepey texture from thin skin. Each answers to a different tool, so assessment comes first: botulinum toxin for the muscle, skin boosters and polynucleotides for skin quality, and filler only where a true hollow exists.
Dynamic lines appear when you smile and vanish at rest — muscle-made. Static lines stay etched at rest — collagen-made. Crepey texture is neither a line nor a wrinkle but skin quality itself: thin, finely wrinkled all over, like tissue paper. Most under-eyes past thirty-five carry a blend, and each component answers to a different treatment.
Filler treats hollows — see tear trough refinement — but placed into crepey, finely-lined skin it adds weight to a surface that needs quality, and often magnifies the crepe. The honest sequence treats the skin first: BTX for the muscle component, skin boosters and polynucleotides for the quality component, energy devices where laxity contributes. Filler enters only where a true hollow exists.
Dynamic smile lines and crow’s feet respond to precisely dosed botulinum toxin — softening the crease-maker while preserving your natural smile; overdosing here is what creates the frozen look this clinic deliberately avoids. Static etched lines need collagen: fine-gauge skin boosters and polynucleotide (PN) treatments such as Rejuran work on the skin itself, hydrating and thickening the dermis so lines sit shallower.
Crepey texture — the tissue-paper quality — is a dermal-thickness problem: polynucleotides, boosters and conservative energy-based tightening address the quality of the canvas rather than any single line. Progress in this zone is gradual and cumulative; the periorbital area rewards a light, staged hand and punishes anything dramatic. Where lines ride on top of a true hollow or a bag, the sequence is planned with the eye bag assessment so treatments help rather than fight each other.
Dynamic lines from the orbicularis muscle — softened with precise, conservative BTX that keeps your smile yours.
Lines that remain at rest — treated through the skin’s collagen with boosters and polynucleotides, not by filling each crease.
The fine all-over texture of thinned skin. Skin-quality treatment, staged conservatively, is the honest tool here.
Where a tear-trough hollow and lines coexist, sequence matters: quality first, and structural support only where a real hollow exists.
For younger eyes showing the first dynamic creasing, conservative BTX and sun protection change the trajectory more than any later correction.
Heavy filler into crepey skin, and overdosed BTX that flattens expression. The eye area forgives neither.
“Filler fills a hollow. It does not iron a line — and under the eye it often deepens the crepe it was meant to hide.”Dr Sin Yong
Reference: Rohrich RJ, Pessa JE. The fat compartments of the face: anatomy and clinical implications for cosmetic surgery. Plastic and Reconstructive Surgery. 2007;119(7):2219-2227.
Your lines are examined at rest and in animation, separating dynamic, static and crepe components — and checking for hollows and bags that change the plan.
Each component is assigned its tool: BTX for muscle, boosters/PN for skin quality, energy for laxity, structural assessment only where hollows exist.
“Lines under the eye can be crepey skin, a hollow above them or swelling, and each needs a different answer.”
Dr Sin YongOn under-eye lines
Fine-gauge, low-volume, staged work — the periorbital standard here. Comfort is managed and expression preserved.
Skin-quality treatments are cumulative; response is reviewed and the plan built gradually rather than front-loaded.
People who expect filler or a single injection to iron out etched lines or crepey skin tend to respond poorly, because lines and crepe are skin-quality problems, not hollows.
Tiny injection marks, mild redness, swelling and bruising are expected and settle on their own. Under the eyes, the skin is thin, so bruising can be more visible. With botulinum toxin, uncommon effects include temporary eyelid heaviness, asymmetry, dry or watery eyes and a flattened smile if dosing or placement is off. Filler in this area can cause lumps, puffiness or visible texture. Infection and blocked blood vessels are uncommon but serious. Risk is reduced by examining the lines first, using conservative, staged dosing and fine-gauge technique, and avoiding filler in crepey skin.
The fee depends on which components are present (movement lines, etched lines, crepey texture), the product chosen, the number of areas treated and whether treatments are combined, for example with energy-based tightening. The treatment plan may also differ if a tear-trough hollow or eye bag is assessed at the same visit. A written quote is given at consultation after your lines are examined at rest and in animation. The consultation also decides whether treatment is advised at all.
How quotes work at this practice: how we quote.
Filler answers hollows, not lines, and in crepey skin it can add weight and make the texture more visible.
Conservative dosing and correct placement are designed to soften the crease while preserving a natural smile.
Usually not — filler answers hollows, not lines. Injected into finely wrinkled or crepey skin it adds weight and often makes the texture more visible. If a true tear-trough hollow coexists, that is assessed separately and treated with restraint.
Treatments that improve the skin itself: polynucleotides and fine skin boosters to hydrate and thicken the dermis, conservative energy-based tightening where laxity contributes, and disciplined sun protection. Improvement is gradual and cumulative — anyone promising instant smoothing is describing make-up.
In experienced hands, with conservative dosing and correct placement, periorbital BTX is a routine treatment. The goal here is a softened crease with a preserved smile — never a frozen eye.
The skin there is the thinnest on the face, over a muscle that moves with every smile and squint, in a zone that catches sun. Thin skin plus constant motion plus UV is simply where lines begin.
Polynucleotides are DNA-fragment preparations injected superficially to support skin repair and dermal quality — used in the under-eye zone precisely because it needs quality more than volume. It is a skin treatment, not a filler.
With the examination that separates them: bags are a structural lower-lid issue, dark circles have four possible causes, and lines are the skin story above both. The sequence is planned so each treatment helps the next rather than fighting it.
The fee depends on which line types are present, the product used, the number of areas treated and whether treatments are combined. Dr Sin Yong examines your lines at rest and in movement, explains which tool suits each component, and gives a written quote at consultation. Because the plan differs for lines, bags and hollows, no figure can be given before assessment.
It tends to suit people whose lines are mainly movement-made or whose skin is thin and crepey, and who are happy with gradual, cumulative change. It is less suitable for those expecting filler to iron out lines, or whose main concern is a structural eye bag, which needs a different assessment. Consultation decides which group you belong to.
No duration is promised. Botulinum toxin effects wear off gradually as the muscle recovers, while skin-quality treatments build over a course and then need maintaining. Longevity depends on the line type, your skin, muscle strength, sun exposure and habits such as squinting. Dr Sin Yong sets review timing at consultation and adjusts it to your response.
Progress is gradual, so it needs patience, and several treatments may be combined. Bruising can show easily on thin eyelid skin. Botulinum toxin can occasionally cause eyelid heaviness or a flattened smile, and filler can magnify crepe or cause lumps. No option replaces sun protection, and bags or marked laxity may need a surgical referral.
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Medically reviewed by Dr Sin Yong, MBBS (NUS), MRCS (Edinburgh) · Last updated 7 October 2026 · Editorial policy
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1. Trinh LN, McGuigan KC, Gupta A. Delayed Complications following Dermal Filler for Tear Trough Augmentation: A Systematic Review. Facial Plast Surg 2022;38(3):250-259. PubMed