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Kenneth D. Steinsapir, MD answers: Options for minimizing remaining eye bags after Blepharoplasty?

I am a young-looking 55 year old. I had lower Blepharoplasty over 3 months ago to correct what I thought were eyebags, but I'm not happy with the results. I still have the eyebags, and now I have undereye wrinkles, and one of my eyes appears bigger (I know some asymmetry is normal, but it wasn't noticeable before).

After doing a lot of reading, I now realize that the "bags" are probably malar mounds or festoons. My doctor is recommending a chemical peel to minimize the "bags" rather than any surgical revision. How does a chemical peel compare with the various laser options? What are my other surgical and non-surgical options, and should I go to an ocular plastic surgeon at this point?

Kenneth D. Steinsapir, MD
14 months ago

I am in the business of fixing other surgeon's eyelid surgery results. Flat out, it is impossible to definitively answer your question without a personal consultation. For the right patient, a chemical peel can be helpful for addressing malar festoons and reducing or eliminating lower eyelid wrinkles. I often do just a lower eyelid peel without surgery to flatten the herniating orbital fat and reduce eyelid wrinkles. The key is proper patient selection. Generally the people who do the best with this approach have a very light (but not too light) complexion and reasonable skin thickness.

However, you are only 3 months out from your surgery. I would advise that you should heal for another 3-6 months before doing anything else. I would caution you regarding having the same individual revise your result. It is a simple test really. If you had ultimate confidence in your surgeon, it is not likely that you would be on this board looking for answers. The book "Blink" tells us to trust our first impressions. You are best served seeking out a truly experienced eyelid surgeon in your area or traveling to seen someone who specialized in fixing these types of problems. Your surgeon may be great at noses or breast surgery but your brain is questioning your confidence in this person as an eyelid surgeon. Please listen to your gut feeling.

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