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Skin Wrinkling After Lower Blepharoplasty

I had lower Blepharoplasty done 2 weeks ago. Swelling still remains, which is normal. What I noticed recently is the exessive skin wrinkling on the lower lidsas the swelling goes down. What should I do to eliminate wrinkling? Could it become permanent?

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17 Doctor Answers | Asked by matreshka in USA, New York

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Wrinkling can occur if excess skin exists before blepharoplasty

Wrinkling after a lower blepharoplasty can occur if excess skin exists preoperatively. Once the fat is removed from the lower lids, excess wrinkling can occur if not addressed. On most patients over 50 years of age there is some wrinkling that is present, and this is removed through an incision located at the lash line, and a small conservative amount of skin is removed from the lower lids and closed with Histoacryl tissue adhesive.

Wait for now, then here are the options

Postoperative swelling is of course the rule after blepharoplasty. There is a phase when the eyes can appear "crepey". Waiting until swelling subsides, typically six months, is the standard answer. The nature of the problem may depend on what was there before the surgery. If there was loose skin present below the eye and nothing was done about it, the loose skin will still be there. If a transconjunctival blepharoplasty was done, with strict fat removal, this can cause the... more

Fraxel re:pair treatment

Waiting for at least six weeks is appropriate before determining if you need treatment of the wrinkling. As stated on this blog, blepharoplasty alone does not address the crepey lower eyelid skin. A resurfacing treatment performed in conjunction witha minimally invasive blepharoplasty can take care of both crepey skin and puffiness. My choice for resurfacing of crepey skin is the Fraxel re:pair laser, which is a fractionated CO2 laser developed by the originators of fractional laser therapy. more

Wait at least 6 weeks

Lower lid blepharoplasty causes swelling and as the other doctors have said-it takes time to resolve. You can better evaluate the wrinkling at 6 weeks. It is NORMAL for wrinkles of the lower eyelid to look worse as swelling is coming down, because the swelling expanded the skin and the swelling leaves quicker than the skin elasticity can be restored. After 6-10 weeks you will be better able to evaluate the wrinkling. Blepharoplasty alone does not remove eyelid wrinkles-in my experience some... more

Was skin removed?

Part of the pre operative evaluation for lower blepharoplasty surgery is to assess the amount of skin present. Your surgeon has made a determination as to whether you needed skin removed or not. If you did, then there should be stitches under your lower eyelashes. If you did not, then the surgery was probably done through the inside of the lower eyelid (transconjunctival). Sometimes, the assessment by the surgeon may be slightly inaccurate and someone who was thought not to need skin... more

Give it some time, you may be surprised at the improvement

Matreshka, 2.5 weeks is fairly early to start getting worried about your eyelids after blepharoplasty. Often it takes several weeks to months for the tissues to settle and the swelling to resolve. At the same time, the tissue is healing and the collagen is reorganizing. All of this leads to changes after surgery which may not be apparent yet. However, if after several months you do not see a significant change and still see extra skin, you can have a straight-forward revision or... more

Do absolutely nothing for at least four months.

Correcting the lower eyelids is one of the trickier cosmetic surgery procedures. In a young face, you cannot tell where the cheek ends and the lower eyelid starts. There is no sharp line between them. So, with surgery, you should try to recreate this smooth, seamless transition. You also have to preserve the shape of the eyes and not make them round. There are many different ways to correct the lower eyelids and imperfect results are not rare. But at 2 weeks, you should not look at... more

Allow more time for healing

Hello, Excellent advice given to you by Dr. Freund. I would also add that since you are only two weeks removed from your surgery you need to allow more time for further healing to occur before making a final assesment of your results (ie. the wrinkling skin on your eyelid). Once the swelling has gone done, the underlying scar tissue has formed (this is good & normal scar tissue formation), the lymphatic drainage has been normalized and your skin has "settled in", you can... more

Kamran Jafri, MD

New York Facial Plastic Surgeon

www.custom-lift.com

Eliminate Eyelid Wrinkling with Fractional CO2 Laser or Skin Tightening

Puffiness under the eyes can mask wrinkles which were already present. In my practice I offer options such as the Mixto SX microfractional CO2 laser and Pelleve’ for people with darker skin. Permanence is relative however you can expect results from these treatments to last for years depending on your health and lifestyle.

Wrinkling under eyelid

Wrinkles under the eyelid are not necessarily treated by a lower eyelid blepharoplasty. The fine lines and wrinkles are often treated with a skin resurfacing procedure such as a chemical peel or a CO2 laser peel (regular or fractional). The lower eyelid blepharoplasty is aimed to treat bags under the eyed that result from fat pads that protrude with age. These should be better after blepharoplasty surgery.

Jacob D. Steiger, MD

17 reviews

Boca Raton Facial Plastic Surgeon

www.drsteiger.com

Eyelid wrinkles

It is still early in the recovery period and would ask that you allow everything to heal. Lower blepharoplasty is a good procedure to rejuvenate the lower eyelids, by removing the lower eyelid fat and some of the wrinkles. However, it will not remove all of the wrinkles.

Treating wrinkles after Blepharoplasty

Unfortunately, lower lid blepharoplasty is not a great procedure for wrinkling under the eyes. It is good for removing bulging, fat-causing bags. Wrinkles under the eyes can be difficult to treat. Treatment may involve skin removal, fillers, or resurfacing procedures. While each case is different, the first important step is determining the cause of the wrinkles under your eyes, but again, this can be a tough problem.

Skin wrinkling after lower eyelid surgery should be left alone until fully healed from the operation.

It is impossible to make judgments about the aesthetic outcome of your operation 2 weeks after the procedure. You should wait until you are fully healed and then asses the results. If wrinkling is persistent, there are various treatments that might help. Now is not the time to employ them.

Skin Issues Following Blepharoplasty

You should definitely wait longer before making any judgements about your surgical result. It may take up to several months for your skin to fully heal from the blepharoplasty. In the meantime, leave it alone other than your normal skin care routine. If there is persistence of the fine lines after adequate time to heal, you may be a candidate to have a chemical or laser peel to further augment your results.

Lower lid skin wrinkling after blepharoplasty

During the process of healing, skin growth is increased and you may experience a bit more accumulation of the upper layer of cells that makes the skin appear drier. This, along with stretched skin from swelling, may make fine wrinkles very prominent for several weeks. Allow the eyelids to heal and apply a little moisturizer to the skin. Be sure to discuss your concerns with you doctor.

Too early to evaluate excess skin after Blepharoplasty

2 weeks post-blepharoplasty is too early to evaluate the excess skin. There is often alot of swelling after a blepharoplasty, and you have to give the skin some time to go back to normal.

Steven Wallach, MD

12 reviews

Manhattan Plastic Surgeon

Lower lid wrinkling has many causes

A lower lid blepharoplasty can remove 1- excess skin, 2) excess and herniated fat and 3) tighten the muscles and ligaments of the eyes. Surgeons have different techniques that address all or some of these problems. To address the herniated and bulging fat, surgeons can remove the fat from inside the eyelid (transconjunctival approach) or through an open approach (skin muscle flap). The loose muscle and ligaments must be addressed through an open approach, but if the ligament is all that... more