The operative word in your question is efficient. Most definitions of
efficient indicate achieving desired result quickly. I would have concern that
even if the laser or peel caused the desired result quickly. Your recovery
would be prolonged with red colored skin for several weeks. Dr Wong’s suggestion
of the pinch blepharoplasty would also be my choice to correct you skinfolds in
the most efficient manner.
Michael Sadove, MD
Thank you for your picture. I do not believe that peels are going to be your answer. I feel that a thoughtful lower lid blepharoplasty will provide more improvement. Consult with several BC PS.
There is obviously some skin excess in the lower eyelid. Both Phenol peel and CO2 laser has some ability to contract the skin, but the downtime and risk far supersedes the benefit. On the other hand a Lower eyelid Blepharoplasty will give more definitive result which outweighs the risks in experienced hands.
would love to see some more pictures, with you not smiling and another with you looking up with your eyes, to see if this is a result of animation, a excess of skin or loss of skin elasticity
Non-surgical options are always very attractive. However, both deep chemical peels and laser resurfacing are unlikely to eliminate the crêpe paper changes that trouble you. Further, the downtime from these non-surgical procedures will likely be more significant than a lower blepharoplasty from which you would be well healed by 7-10 days. I hope this information is helpful.
Stephen Weber MD, FACS
Denver Facial Plastic Surgeon
Your best option would likely be a surgical lower lid blepharoplasty. Skin resurfacing procedures whether, chemical peels or lasers are best applied to an entire aesthetic unit such as the entire periorbital area (upper and lower lids). Moreover, they are more effective for very fine wrinkles and skin discolorations, not excess lower eyelid skin folds which is what it appears is your issue. Best of luck.
I think they would both be bad choices with some risks that might require long term makeup to cover. With your lids a skin only resection carries very little risk and the scars are usually very hard to find and you will get a significant improvement.
can be accomplished with what you have mentioned but they come with longer healing times than most males can handle, including the possible use of make up to conceal color changes. If you were in my office, I would be suggesting a pinch lower lid blepharoplasty as I have had one myself. Could use another one though....
It is normal and appropriate for the eyelids to wrinkle when smiling. even when there is no excess skin as in younger patients. The diagnostic question here is really "is there excess skin that can be safely corrected best by resurfacing (LASER or peel) or by surgery? An experienced eyelid plastic surgeon will evaluate the skin particularly with the eyes looking up to see if there is a correctable problem. Often there is no excess skin in a 40 year old and the resurfacing is a better choice than surgery, particularly when the is no fat bulging or "tear trough" hollowing.
LASER resurfacing is safer than phenol and loss of pigment rarely occurs but the degree of skin shrinkage is minimal but also uncertain with resurfacing compared to surgery.
Botox is appropriate for "crows feet" wrinkles but may cause the lower lid to droop if injected below the lid for wrinkles such as those depicted.
A consultation with an experienced eye lid surgeon who also does LASER would be appropriate.
I would strongly advise you to avoid all of the above. noninvasive blepharoplasty replacements sound great and they can erase wrinkles and tighten things up considerably but unfortunately this is ALWAYS at the expense of eyelid function. If you look carefully at any laser or peel results that show the entire face you will see development of an unattractive bowing of the lower lid and even lagophthalmos preventing complete eye closure. Besides creating a saddened or aged eyelid shape this can also lead to painful dry eyes and even corneal opacification in some cases. Patients are usually very happy immediately after these procedures as they do clean up the loose skin, but over time the scarring and dysfunction that is caused can be miserable.
There is no replacement for a well planned and executed blepharoplasty tuned to the aesthetic and functional needs of the individual patient. Do not destroy your eyelids looking for an "easy way" as you will likely need a reconstructive blepharoplasty in the future if you do.
I hope this helps!
All the best,
Rian A. Maercks M.D.