Always Look Tired with Creases and Wrinkles Under my Eyes

Patients not desiring surgery benefit most from fillers, chemical peels and Botox. Patients with a fat bulge often benefit from transconjunctival fat reduction or fat redistribution procedures. Patients who have loose lower eyelid skin are often candidates for a cheeklift with tightening of the lower eyelid skin. In our practice we do not favor removal of skin from the lower eyelid without commensurate support. In all surgical cases, we evaluate whether addition of volume, i.e. grafts of... more

No one treatment is the answer for every lower eyelid concern. In fact I give talks on this subject in which I describe the thought process that I go through when evaluating my own patients. If the problem is puffiness alone, then the correction involves a transconjunctival (incision free) removal of prolapsed infraorbital fat. If the problem involves puffiness and skin excess or laxity, then the correction may require an incisional blepharoplasty where both fat and skin are removed in... more

There are many treatments for the lower lids and what is best depends on your anatomy. Fillers are excellent if you have volume loss (tear troughs) and have young healthy skin. They do not work well in older patients with thin skin. Topical treatments, lasers and peels, and surgery are other ways of rejuvenating the eyes. Make sure you go to someone who can offer all treatments so you can sort out which is best for you, not just the only one they offer.