What Can Be Done for Crepey, Saggy Skin Under the Eyes?

I am in my 40s, with fair Irish skin. My skin looks pretty good except under my eyes- I have crepey loose skin directly under my eye when I smile. (Crows feet are minimal.) I've read that filler won't help though years ago I did get Sculptra in the hollows and thought it looked pretty good. My skin was not as crepey at that point. Can anything be done?

Doctor Answers 13

Crepey, Saggy Lower Eyelid Skin treatment options

First I would address the reason for these lower lid  and crows-feet wrinkles. These type of wrinkles are often seen in patients that squint so first of all I would make sure that if you need visual correction then use glasses or contacts (if not sure, have your vision tested) and use sunglasses on bright days.                                                                                                                                                                                    Now for treatment options, other than the the frequent use of moisturizers, Retinoids like Retin-A, and sunscreens you can consider the use of fillers like Restylane and Juvederm are helpful to decide the degree of benefit from supporting the skin. If you like the effect then consider a more permanent solution like fat transfer. Secondly, a deeper TCA peel, Sciton SkinTyte laser or fractional laser treatments often help. Both fillers and resurfacing procedures are complementary and synergistic in your case. For redundant skin, a conservative skin pinch blepharoplasty may also be of benefit. A qualified board certified aesthetic surgeon will help you find the right treatment for you

Orange County Plastic Surgeon
5.0 out of 5 stars 64 reviews

Options for excess lower eyelid skin

Thanks for sharing your question. For redundant skin to the lower eyelid you have a few options to help tighten this area.  First a fractional CO2 laser will help treat this loose skin. Similarly a medium depth chemical peel such as Jessner's /TCA 35% will also work. Surgically a skin pinch or skin only lower lid blepharoplasty will help to remove the excess skin directly. Consult with a few board certified surgeons and dermatolgists to review your options. 

Raymond E. Lee, MD
Orange County Facial Plastic Surgeon
5.0 out of 5 stars 43 reviews

Several options for crepey skin under eyes

Under the eyes wrinkles that occur with smiling are often very successfully addressed using an injectable neurotoxin such as Botox.  This area does have a slightly higher risk of bruising than other areas Botox is typically used.  

With regards to crepey, loose skin there are several surgical and non-surgical options to improve the tone of your skin.  One option that is associated with no down time is skin tightening using a radiofrequency device such as Exilis or Ulthera.  These devices deliver a controlled amount of heat to the deeper layers of the skin which in turn stimulates fibroblasts to make new collagen.  Over the following weeks-months this new collagen contracts and tightens up the treated skin giving a more youthful appearance.  Exilis usually requires 4 treatments spaced 3 weeks apart while Ulthera usually requires 2-3 sessions.

Laser resurfacing is another option that usually only requires one session.  The down-side is that the first few days after the treatment your skin will be swollen and red as it heals.  The upside is that it requires only one session and gives excellent results after just a couple of weeks. 

Tif Siragusa, MD
Nashville General Surgeon
5.0 out of 5 stars 2 reviews

A combination of resurfacing treatments plus very conservative surgery should help.

Without an examination, it is difficult to say for sure. If the crêpey appearance is as minimal as it sounds, you could see great results from laser resurfacing to tighten the surface of the skin and promote collagen production. Alternatively (or perhaps in addition), you may consider a very, very conservative blepharoplasty (eye lift surgery), but be sure to choose a highly qualified cosmetic surgeon with a lot of experience working on the eye area. And finally, invest in a nourishing night cream and an outstanding sunscreen and use them both religiously to further protect your skin’s firmness and elasticity.

Crepey Loose Lower Eyelids

Crepey loose lower eyelids may be improved with surgical and nonsurgical treatments.  Depending on the individual situation chemical peels, lasers and or surgery can be performed to improve the lower eyelids.  It is recommended to be evaluated by a plastic surgeon to discuss the various options.

Craig Mezrow, MS, MD
Philadelphia Plastic Surgeon
5.0 out of 5 stars 9 reviews

There are many options available for you to treat under-eyelid skin

Creepy loose skin under the eye can be improved with Retin-A, good sunscreen and moisturizer, or mild chemical peels.  If more wrinkles than usual are present, a heavier chemical peel, laser or skin blepharoplasty will also improve this.  For depressions or hollows, usually hyaluronic acid fillers are good and also reversible in case of small lumps or irregularities caused by this.  The main thing is to go to a provider who has experience in these areas and build a long-term relationship with them so they can guide you through this process.

James Carraway, MD
Virginia Beach Plastic Surgeon
4.0 out of 5 stars 6 reviews

What Can Be Done for Crepey, Saggy Skin Under the Eyes?

This is a very common problem. Botox is usually the "go to" option for treatment of wrinkles related to excessive muscle movement. However, overtreatment of the area below the lower eyelid (not crow's feet) can result in temporary drooping of the lower lid. Therefore, these lines are best treated either with CO2 laser resurfacing or lower blepharoplasty. I hope this information is helpful.

Stephen Weber MD, FACS

Stephen Weber, MD, FACS
Denver Facial Plastic Surgeon
5.0 out of 5 stars 77 reviews

What Can be Done for Crepey, Saggy Skin Under my Eyes

My recommended treatment plan  for Crepey, Saggy Lower Eyelid Skn would depend upon a examination but I will do my best to respond.  First I would not recommend a laser resurfacing procedure at you age.  The reasons are:  1. SLOW RECOVERY 2. A difficult post-laser treatment plan.. I would therefore recommend a plan that is less aggressive and will give you about a 25% to 40% improvement:
Profractional Laser Twice per year
Microlaser Peel once per year
•  Plus or Minus a Peleve' treatment: 3 times per year.
• Topical Tripeptide Cell Activator (with Stem Cell) Topical
This will give a good maintenance approach and avoid the overly envasive Full Laser Resurfacing which may be required in your 50's.

Joseph Rucker, MD, FACS
Eau Claire Plastic Surgeon
4.0 out of 5 stars 7 reviews

What Can Be Done for Crepey, Saggy Skin Under the Eyes?

Laser Resurfacing around the eyes is a great way to re-stimulate more collagen growth, smooth out crepey skin and tighten the skin.  We offer the DOT Co2 Laser.

Stuart B. Kincaid, MD, FACS
Beverly Hills Plastic Surgeon
4.0 out of 5 stars 9 reviews

Treatment for crepey, saggy skin under the eyes

In my office, we have had the best results treating fine lines, crepey and saggy skin, and dark circles under the eyes using Neocutis Lumière Bio-restorative Eye Cream. Lumière contains a complex blend of human growth factors, cytokines and Interleukins, hyaluronic acid, and caffeine. For your convenience, Lumière can be purchased online from TheWebDermatologist.com.

Mitchell Schwartz, MD
South Burlington Dermatologic Surgeon
5.0 out of 5 stars 10 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.