Crepey Skin and Hollow Eyes After Blepharoplasty

I am 62, and have had lower Blepharoplasty 10 years ago. Now, my under eyes are sunken and the skin has a crepey appearance? What can be done for these?

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24 Doctor Answers | Asked by Va9503 in Vienna,Va.

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Composite fat grafting to plump the hollow eye and fractional laser resurfacing to remove wrinkles

Dear Va9503, The hollowness or sunken area occurs because fat was removed during your blepharoplasty and during the past 10 years, the cheek fat pad has descended lower in the face. As our faces age, depressions and a hollow look below the eyes is very common. The crepiness of the skin is caused by skin aging, which thins the skin and repeated motion of the eyelid muscle beneath the skin, which causes the eyelid skin to form wrinkles. Excellent results and improvement in the sunken look or... more

Correcting Hollow eyes post over aggressive blepharoplaty

My approach to upper eyelid surgery is to be conservative with skin excision, and to reserve excision of fat for patients with significant fat excess. In my opinion, aggressive removal of upper eyelid skin and fat is a 'skeletonizing' procedure which risks making eyes appear more deep-set and aged, rather than younger. In fact, in many patients I perform structural fat grafting (using the patient's own fat, from the abdomen or hips) to help restore soft tissue volume around... more

Michael Law, MD

17 reviews

Raleigh-Durham Plastic Surgeon

michaellawmd.com

Lower blepharoplasty usually causes sunken appearance

Lower eyelid blepharoplasty entails fat removal and skin removal from the lower eyelids. This is part of the reductive philosophy that has dominated surgeons, and plastic surgeons. An analogy is that of a grape when it loses its volume and turns into a raisin. Based on traditional approaches, a plastic surgeon would take that raisin and remove the skin of the raisin to make it into really just a smaller grape. But based on this analogy, the smaller grape would not look like the grape that... more

Philip Young, MD

6 reviews

Bellevue Facial Plastic Surgeon

Crepey Skin and Hollow Eyes After Blepharoplasty

Plastic surgery, like all science, evolves over time. It was once thought that removing more skin and fat was better. We now know that we lose tissue volume as we age, so it is imperative to create an aesthetic change while preserving volume. Modern blepharoplasty techniques try to reposition fat or minimize tissue resection so that the result is longlasting. Having said that, we cannot reverse the aging process (yet!). So even after surgery, you will continue to age, bu... more

Crepy eyelid skin after lower blepharoplasty

Crepy eyelid skin after lower blepharoplasty can occur many years after a primary blepharoplasty procedure. This is often the result in the loss of elasticity in the lower eyelid skin with the aging process exacerbated by a previous surgery. Often a chemical peel or CO2 laser can improve that appearance. I would not recommend any additional lower eyelid skin removal since it can result in a pulled down eyelid appearance or create rounding to the lower eyelid area. As far as the hollowed... more

Scott Trimas, MD

3 reviews

Jacksonville Facial Plastic Surgeon

www.facesonly.com

Removing a small amount of skin and fat injections

The crepey skin on the lower lids can be excised through a subciliary incision and a small amount of skin can be pinched and removed so as to conservatively help with the wrinkles. This is usually glued with Histocryl tissue adhesive. Any hollowing under the eyes can be addressed with fat injections into the orbit to give more fullness.

Crepey skin and volume loss after Blepharoplasty

There are so many factors that contribute to the appearance you describe but generally they are associated with loss of facial fat and skin elasticity with time and environmental damage. HOLLOW EYES: You may want to contemplate using injectable fillers to "try out" the appearance of a fuller lower eyelid. If you like them, you could consider a long term solution such as fat injection, open fat repositioning/grafting, or cheek lift with SOOF or malar fat pad suspension. CREPEY... more

Otto Joseph Placik, MD

33 reviews

Chicago Plastic Surgeon

Lower Blepharoplasty volume loss

There have been changes in the way surgeons perform lower blepharoplasty. The general trend in lower blepharoplasty is toward conservation of the lower eyelid skin, preservation of lower orbital fat, avoiding tension on the lower lid, performing a canthopexy or canthoplasty, and filling the tear-trough depression. It sounds like your surgeon removed too much orbital fat, which along with the normal volume loss with age has contributed to the depression below your eyes. I would recommend a... more

Time for another repair or maintenance procedure

Ten years ago, the standard blepharoplasty involved elevating the skin and muscle layer of the lower eyelids and removing the excess fat. At that point it was considered the correct operation. With the passage of time and improved understanding of the aging process we have come to believe that the fat of the face is a precious commodity and should not be removed in all cases. It can look good initially but with time and aging, the upper face and orbital areas become skeletonized. There... more

Adding volume is an option

What most likely has happened is that during the first procedure, too much of the fat was removed, leaving a hollow, sunken look over time. Loose skin has also developed. A non-surgical option would be to treat the crepey skin with a laser, such as the Fraxel repair, and add volume to the hollow rim with either fat or a filler such as Juvederm. This would spare you an additional surgical procedure that risks lower eyelid rounding.