Loose Skin Under Eyes After Blepharoplasty

I had Blepharoplasty done over a year ago but still have loose skin under my eyes. I have had CO2 laser done to correct this, but it did nothing. A doctor recommended Fraxel, but I've read it does nothing for skin tightening. I want to spend my money doing what's going to work. Could you suggest what I can do to get this fixed? I was considering lower eyelid surgery again. Is this necessary?

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13 Doctor Answers | Asked by hawaiiangirl in Georgia

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Loose skin under the eyes

It is difficult to know exactly why you have loose skin under your eyes after lower blepharoplasties and CO2 resurfacing, but the problem should not be difficult to fix. As long as the overall result is satisfactory i.e. the fat protrusion is gone, you probably just need a very conservative skin pinch. If your lids are loose or there is still "bagginess" under the eyes for example, you may then need to have lower blepharoplasties performed again.

Be cautious! Re-doing lower eyelid blepharoplasty

Be very cautious pursuing further treatment for your loose lower eyelid skin. The fact that you have already had a blepharoplasty performed and CO2 laser puts you at risk to develop complications such as pulling down of the eyelid (retraction) or pulling out of the eyelid (ectropion). You may want to really assess the results and consider if your expectations are realistic. If your surgeon feels that you can have a minor touch up safely Fraxel:repair can tighten eyelid skin. ... more

Pinch will remove excess skin

There is a technique for the lower blepharoplasty, which involves a pinch of excess skin on the lower lids. This can be done under a local or general anesthesia and is typically done when excess eyelid skin is present at rest and not upon animation. It is very important to take a conservative pinch of lower lid skin so that there will be no change in the shape of the lower eyelid structure.

See an expert

Depending on your age and the amount of skin laxity there are different things that can be done. I would be wary of doing another CO2 laser treatment although the fractional CO2 lasers safer to use in my experience. If there is a slight "crepiness", then a superficial laser resurfacing may be in order but make sure that the physician treating you has experience in this area. The same goes for removal of excess skin. As one of the other commenters stated, removal of too much... more

Be careful about too many procedures around the eyes

You really need to be careful about too many procedures around the eyes performed in a short period of time. If you post some pictures, we may be able to give you more specific advice. However, you may want to review your pre-operative pictures to appreciate the difference that you already have. It may be impossible to smooth out your skin 100% without leading to other problems. Hopefully, you have had open and honest discussions with your surgeon. Good luck.

Three options but you should first get a good medical advice

Only a clinical exam or at least a picture will allow a plastic surgeon to give you the best advice. The options you have: 1. Do nothing for now. 2. CO2 ( which you already did) 3. Revision. In any case, get a good advice from a board certified plastic surgeon in your area.

Fraxel will not tighten lower eyelid skin after Blepharoplasty-please see an expert

Fraxel will not tigten the skin, save your money. If an adequate depth CO2 resurfacing had been done you should have seen a difference. I would not repeat the CO2-the problem with flat beam CO2 is that adequate depths of peel to tighten the skin and remove wrinkles could leave your skin white and pull the lid down into a sad eyed look or ectropion. You need to be examined by an epert plastic sureon who is very experienced in eyelid surgery and laser surgery-there are not many. The problem... more

Careful diagnosis needed

Loose skin is a descriptive term, not an anatomic one. A careful examination and a meticulous analysis will point you in the right direction. Loose skin could refer to a textural/qualitative condition due to loss of elasticity and surface etching or fine wrinkles. It could refer to contour changes from fat herniation in conjuncton with oribital rim hypoplasia causing the skin to hang like a beer belly would. It could refer to true excess of skin surface area as seen with actual folds or... more

Robin T.W. Yuan, MD

4 reviews

Beverly Hills Plastic Surgeon

Loose skin is in the eye of the beholder.

Dear Hawaiian Girl It is very difficult to provide a meaningful answer to your question without knowing more about your situation. What you perceive as loose skin maybe viewed as an acceptable post-operative result to your surgeon. We don't know how deeply pigmented you eyelid skin is. This may have something to do with how agressively your first surgeon laser resurfaced the lower eyelid skin. I would disagree that laser resufacing is the best lower eyelid skin tightening treatment. ... more

Kenneth D. Steinsapir, MD

8 reviews

Los Angeles Oculoplastic Surgeon

The question is why.

You have already had the most effective methods of tightening the lower eyelid skin. There can be many reasons for continued laxity of the skin. Only examination by a skilled Plastic Surgeon who does a lot of work around the eye can determine what the problem is in your case. Sometimes a re-do blepharoplasty will be necessary. This will have to be done differently than the first one, however, to achieve different results. Usually this requires separating the lid into components, detaching... more

Surgery may very well be the best choice

Lower lid blepharoplasty can definitely be tricky. One of the best decisions that a surgeon can make when faced with skin to be removed is when in doubt take less rather than more. Removal of too much skin is a disaster. The problem of course is that now your still left with too much skin. CO2 laser is excellent to tighten and resurface skin. Fraxel is simply fractionated CO2 so if the laser you already got didn't do anything neither will Fraxel. My recommendation would be for a... more

CO2 laser

The most effective skin tightening laser I have used is the good old CO2 laser. It is a bit rough on the recovery in terms of oozing, swelling, and redness. The other thing to conside is a re-do bleph. You may simply have so much excess skin that you need to have it removed. Be advised however, you delicate eyelids have had multiple procedures already, and you are at increased risk for sagging lower lids. So be very sure to tell whomever works on those lids, your complete history here... more

Loose skin after Blepharoplasty

There are numerous modalities for skin tightening but most of these provide insufficient correction. Without photos and the ability to assess lower eyelid skin/muscle/ligament tone, vectors, and other anatomic/physiologic facotrs, it is difficult to make a recommendation via this format. Perhaps you would want to post a picture. You could benefit from a skin peel such as TCA at the least or you may need a complete revision blepharoplasty. Get a least two opinions from surgeons. more