Seeking Lower Eyelid Surgical/non-surgical Suggestions?

47 y.o. female ready to do more than botox for my eye area (and cheek area?). My eyes at rest appear youthful (yet with flatter midface) but, when I smile (even just a tiny smile!) horrid, horizontal, rolls of skin bunch beneath my eyes. More so under right eye. Several ~ 1/4" rolls extend about 3/4" under my lower lid. I am slender. Is this likely fat protrusions or excess aging skin? Muscle? Have lower blephs been helpful excising rolls without changing shape of eye too greatly? Other ideas?

Doctor Answers (8)

Surgical option for excess skin in lower eyelids

+2

We do not recommend the use of any fillers around the eyes.  Botox can certainly be used for crow’s feet laterally around the eyelids.  The decision to remove any skin on the lower lids is performed at rest, not upon animation.  The reason that excess skin is bunching up upon animation is that the muscle is contracting the thin skin underneath.  The primary goal of lower eyelid surgery is to remove fat bags through the transconjunctival approach and a small subciliary incision is used to remove any excess skin if needed at rest.


Seattle Facial Plastic Surgeon
5.0 out of 5 stars 55 reviews

Blepharoplasty (eyelid surgery) can remove excess skin and fat from around the eyes

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The cause of your excess skin under the eyes could be from a number of factors including hereditary, allergies, fatigue, eye strain, sun exposure, etc. Blepharoplasty (eyelid surgery) can remove excess skin and fat from around your eyes to help restore a more vibrant and youthful appearance. Certain laser skin resurfacing treatments and chemical peels can also be helpful in treating fine lines and wrinkles around the eyes. Sometimes fillers are also used to hide the shadows.   Contact a board certified dermatologist or plastic surgeon in your area to determine if lower eyelid surgery is right for you.

Edmond Griffin, MD
Atlanta Dermatologic Surgeon

Blepharoplasty (eyelid surgery) can remove excess skin and fat from around your eyes to help restore a more vibrant and youthful

+2

The cause of your excess skin under the eyes could be from a number of factors including hereditary, allergies, fatigue, eye strain, sun exposure, etc. Blepharoplasty (eyelid surgery) can remove excess skin and fat from around your eyes to help restore a more vibrant and youthful appearance. Certain laser skin resurfacing treatments and chemical peels can also be helpful in treating fine lines and wrinkles around the eyes. Sometimes fillers are also used to hide the shadows.Contact a board certified dermatologist or plastic surgeon in your area to determine if lower eyelid surgery is right for you.

D. Scott Karempelis, MD
Atlanta Dermatologic Surgeon
3.0 out of 5 stars 1 review

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Many treatments for lower lid wrinkles, and fat pads...

+2

Without photos it's difficult to answer you particularly. In general there are many options  variations and conbinations for lower lid rejuvenation....In my practice, I will generally combine a lower lid blepharoplasty (removal of fat pad) and Co2 laser resurfacing of the lower lids which tightens the skin beautifully, resulting in a much smoother more youthful appearance.

Kenneth A. Marshall, MD, FACS
Wellesley Plastic Surgeon
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Lower eyelid rejuvenation

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Lower eyelid aging varies among each individual. Your problem can be a combination of the factors you described (excess loose skin, rolling of underlying muscle, and/or protruded fat). Depending on the problem, nonsurgical or surgical option may be best.  See an oculoplastic surgeon for evaluation and treatment options.

Mehryar (Ray) Taban, MD, FACS
Beverly Hills Oculoplastic Surgeon
5.0 out of 5 stars 7 reviews

Post photo

+2

Without photos, its impossible for us to give you an accurate assessment. You would need closeup photos of you without smiling, and then smiling.

A.J. Amadi, MD
Seattle Oculoplastic Surgeon
5.0 out of 5 stars 21 reviews

Lower lid blepharoplasty will remove sagging skin.

+2

Lower lid blepharoplasty will remove sagging skin but all patients as they start to age get rolls when they smile. I would need to see you in person or photos to give you a good answer otherwise it  is just a guess.

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 14 reviews

Lower Blepharoplasty

+2

It is hard to say for sure what is protruding without evaluating you.  However, this is usually caused by excess skin or fat.  Depending on the cause, this area can be addressed and improved with a lower eyelid blepharoplasty.  Please consult with a board certified specialist who can best assist you in achieving the results you seek.

Kimberly Lee, MD
Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 8 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.