Eyelid Surgery to Eliminate Lower Eyelid Wrinkling?

asked 2 years ago by SapphireOne9
Latest answer by William Portuese, MD
Question viewed 1,899 times
Tags: eyes, wrinkles, crepey skin

I am 55. I have some crepiness, wrinkling, and now a slight laxity in my lower eyelid skin. I did have CO2 Laser under the eyes when I was 40, which did a miraculous job of tightening and eradicating undereye wrinkles. I've had several mild under eye TCA Peels also, with barely noticeable results. I would repeat the CO2 laser procedure except that I've heard it thins the skin. Would a lower lid blepharoplasty with some very minor skin removal at this stage be the best answer to tightening the skin and eliminating some wrinkling?

10 answers to Eyelid Surgery to Eliminate Lower Eyelid Wrinkling?

Lower eyelid blepharoplasty to tighten lower eyelid skin

Lower eyelid blepharoplasty done through an under the eyelid incision does indeed tighten the skin. However in the process, the lower eyelid can move downward, causing a rounding of the eye or a pulling down in the corner of the eye. We believe strongly that all lower eyelid skin tightening procedures should be supported, that means strategic sutures are placed to prevent a downward drift of the lower eyelid over time. This is NOT synonymous with a canthopexy, which if performed without... more

Brent Moelleken, MD
Beverly Hills Plastic Surgeon

www.drbrent.com

Lower lid blepharoplasty or pinch

The goal of lower lid blepharoplasty is primarily to remove the excess fat bags in the lower lids. If there are no bags present, an additional pinch of lower eyelid skin can be performed at the lash line. This is typically closed with tissue glue for tightening the lower lid skin. This must be done conservatively so as not to change the shape of the eyelids.

William Portuese, MD
Seattle Facial Plastic Surgeon

www.seattlefacial.com

Eyelid surgery a possibility

Sapphire: Your suggestion may be a good course, but in-person evaluation is necessary. You have had several procedures which can improve lower lid wrinkling, and skin excision blepharoplasty might be next. You should also consider that it may not be possible to completely eliminate lower lid skin wrinkling. After consultation with experienced surgeons, consider your situation carefully.

Sutton Graham II, MD
Greenville Plastic Surgeon

Lower lid blepharoplasty

If the skin is wrinkling and you have had previous laser procedures, I would probably encourage you to have a simple skin excision of the lower lid. If the lower lid is lax, then you may need a lid suspension procedure like a canthopexy.

Steven Wallach, MD
Manhattan Plastic Surgeon

I would beg to differ regarding the benefits of CO2 laser resurfacing.

Dear Sapphire One Ultimately you need to find a cosmetic surgeon who makes sense to you. I think that you have to appreciate that at age 55 there is more going on that just too much lower eyelid skin causing wrinkling. CO2 laser resurfacing has been both a blessing and a curse. Many patients have had too much laser treatment for their thin eyelid skin. Even though the skin may have healed, these individuals demonstrate long term atrophy of the skin. The thin rehealed skin does not do... more

Kenneth D. Steinsapir, MD
Los Angeles Oculoplastic Surgeon

Treating lower eyelid wrinkled skin can be difficult.

I always approach the lower eyelids with caution. In fact, I personally don't like to remove excess lower lid skin as an isolated procedure. Your lower eyelid is a free floating border that could get pulled down, and become problematic if too much skin is removed. If your lower lid skin is getting you down, consult an experienced, board-certified oculoplastic surgeon with many favorable post-op photos of people with similar concerns. Best regards.

Eric M. Joseph, MD
West Orange Facial Plastic Surgeon

Eyes are the window to the soul

The eyes are the windows to the soul. All too often, however, they seem to reveal exhaustion. The very delicate skin around the eyes tends to get crepey and puffy due to fatigue and stress. Eyelid surgery has become one of my most popular procedures. If undereye puffiness and dark circles need to be eliminated, an incision is made along the lower lashes that will be almost invisable when it heals. Next, the fat below is either removed or redistributed and the saggy and crepey excess skin is... more

Michelle Copeland, MD, DMD
New York Plastic Surgeon

Laser resurfacing combined with lid tightening is best for crepiness and wrinkling of eyelid skin

The crepiness and wrinkling of the lower eyelid is caused by skin changes, and standard blepharoplasty usually is used to remove fat (bags) and loose excess skin, however, blepharoplasty alone does not change the skin and does not remove wrinkles and crepiness.Laser resurfacing stimulates new collagen production in the eyelid skin and can help wrinkles and crepiness.The concern I have is that since you have had a previous CO2 resurfacing and several skin peels, a standard incisional... more

Brooke R. Seckel, MD
Boston Plastic Surgeon

www.drseckel.com

Well performed lower blepharoplasty probably would be best.

Hi! It's hard to tell exactly without seeing you, but, from your story, in New York we would probably do a lower blepharoplasty. We support and tighten the lower eyelids in good position with a canthopexy, so the lids don't slide down. Then it is safe to remove a surprising amount of excess skin. But technique is everything.

George J. Beraka, MD
Manhattan Plastic Surgeon

Lower eyelid skin wrinkling and CO2 laser

CO2 laser does not thin the skin. On the contrary it actually thickens the dermis over time as the skin repairs itselft from the procedure. If the only issue you have with the lower eyes is skin wrinkling then a combination of good skin care and potentially adding botox and skin resurfacing with a modality that is significant enough to allow improvement should be beneficial. This modality could be a chemical peel of sufficient depth or a laser. Blepharoplasty might also be of benefit as... more