How to Treat Wrinkles Under the Eyes After a Lower Bleph? Will Evolence Work?

Laser resurfacing is most often the answer to wrinkles under the eyes during or after lower eyelid blepharoplasty. Most patients find that their skin has many wrinkles or crinkles due to looseness or laxity of the skin. The CO2 laser does a wonderful job of smoothing and tightening skin. Generally htis is done at the same time as the lower blepharoplasty, but can be done after the surgery. Fillers are mainly effective for depressions, shadows or troughs under the eyelids.... more

As in the previous post, a skin tightening procedure is probably your best choice, whether by more skin removal, chemical peel, or laser. Fillers can help on occasion but I would assess this after addressing the skin laxity. Evolence is a good filler for some areas, because it integrates into the skin and provides good support, but it would probably be a little too firm for under the eyes. If you do end up needing a filler there I would suggest Restylane or Juvederm.

Lag, In lower blepharoplasty, fat and or skin is removed to help improve the contour of the lower lids. In most cases, removing the fat turns convexity of the lower lid into a slight concavity. For this reason, not much skin needs to be excised. Occasionally, there is excess skin after the swelling has resolved. You have several options. First you could have a simple "pinch" blepharoplasty where just a small amount of skin is excised under the eyelashes. This can be done... more

Even after tightening the skin after eyelid surgery, wrinkling may persist.  Laser resurfacing can reduce and even eliminate the wrinkles.  The CO2 laser is my choice.  There are side effects however and patients need to be fully informed about the downside.  Nevertheless, it is generally a very excellent treatment in the properly selected patient.

It is important to understand that wrinkles on the eyelid skin are actual indentations in the skin--permanent skin creases caused by sun damage and aging woith loss of skin collagen. Simply excisiong more skin or injecting Evolence, retsylane or other soft tissue filler will NOT remove a skin wrinkle. The lid will be shortened or the eyelid puffed, but the wrinkles in the remaining skin will still be present. Laser resurfacing will smooth the wrinkles by building new skin collagen. It is... more

Wrinkles underneath the eyelids are caused from excess skin and muscle contraction of the orbicularis oculi muscle in the lower lids. The excess skin has to be measured at the time of repose (not animated). A small strip of skin can be pinched just immediately below the lash line and the subciliary area excised and then closed with Histocryl tissue adhesive. The excess skin is only removed at repose and not on animation. If patients get a lot of wrinkling during the smiling process,... more

To lag, Hi!  Hard to tell exactly without examining you, of course,  but I have had good results in this situation with the dual modality erbium laser made by the Sciton Corp. If the wrinkles become worse when you smile (muscle activity), then  Botox injections might help.

It is very common for patients to have all of the following components prior to eyelid surgery: excess skin, excess fat, and poor quality of skin. Unfortunately, only two of the three are treated with the eyelid surgery: excess skin & excess fat. In addition, the quality of skin is not normally addressed at the same time as the eyelid surgery to prevent damage to the delicate skin around the eyes. In the situation where you have all three components, it is safer and most common to... more