Ask a doctor

What's the Best Treatment for Loose Skin Under Eyes?

i'm 55. I have hollow eyes and have had some fillers used to treat a depression at the outer, lower aspect of the socket, but there is still an issue with some wrinkles caused by a little bit of loose skin. Is skin excision the best way to go?

Doctor Answers (13)

Treating a "little" Loose skin Under the Eyes

+2

The devil is ALWAYS in the details. What some people regard as "little", may in truth, be more formidable and the reverse is also true.  The optimal treatment of the lower lid skin would need to be based on :
- the tonicity and quality of suspension of the lower lid from its attachments on the orbit (a loose hanging lower lid with "white show" would need to be addressed before or at the same time as any lower lid procedures)
- the location and shape of the side corner of the eyes - The Lateral Canthus, especially in relation to the inner (Medial Canthus) needs to be evaluated (it usually goes down with age giving rise to "sad eyes")
- Any vision issues or eye dryness need to be evaluated.


Then, based on these facts, you and your Plastic surgeon will have to decide if:
- laser resurfacing (shrinkage) of the lower lid
- Skin Pinch procedure of the lower lid is the option best suited for you.

Dr. P. Aldea


Memphis Plastic Surgeon
5.0 out of 5 stars 66 reviews

Loose Lower Eyelid Skin

+1
A very careful examination with an experienced surgeon will guide you through your options.

You have very accurately identified the first goal in the most up to date approaches- additional volume.

It sounds as though you have identified a "lateral orbital hollow" as well as some loose skin.  In general I would recommend the following are considered:

1.)  Additional volume with "no down-time" such as Restylane, which you have completed.
2.)  Consideration for natural volume with your own abdominal fat transferred.
3.)  Botox or Dysport (your choice) to lessen the contractile forces of the periorbital muscles (crows feet).
4.)  Potential tightening skin procedures such as chemical peels or fractionated carbon dioxide lasers.
5.)  Removal of  excess skin with pinch blepharoplasty or skin-muscle flap blepharoplasty.

Obviously the best idea is to start with the least invasive and most natural options progressing only as needed to more advanced options.

Best of Luck to You!
Todd Hobgood, MD
Double Board Certified Facial Plastic Surgeon

Todd Christopher Hobgood, MD
Phoenix Facial Plastic Surgeon
5.0 out of 5 stars 20 reviews

Surgical blepharoplasty is the best option

+1

The best treatment for you is a surgical correction.  Some of your orbital fat can be used to fill in the hollowed out areas.  The muscle can be re-suspended laterally ant some of the malar cheek fat can be resuspended laterally as well.  This would be the best way to  get rid of the hollowness and make the dark circles less noticeable.  The darkness is due to the shadowing caused by the hollowness.

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon
5.0 out of 5 stars 10 reviews

You might also like...

Best treatment for loose skin under eyes

+1

At 55 years of age, the best option for loose skin underneath the eyelids is usually a pinch technique done at the subciliary line. This is a technique often done with lower blepharoplasty, but can be done independently. Immediately below the lash line 2 to 3 mm of excess skin is pinched from the lower lids. Tissue glue such as Histocryl is used to close the incision. Another option to help tighten the lower lid skin is fractional carbon dioxide laser resurfacing.

William Portuese, MD
Seattle Facial Plastic Surgeon
5.0 out of 5 stars 60 reviews

Laser and Eyelid surgery to correct loose lower lids

+1

Loose skin under the eyes usually responds well to carbon dioxide laser resurfacing.  The laser energy heats the  collagen fibers in the dermal layer of the skin resulting in contraction and tightening.  Traditional carbon-dioxide lasers such as the Ultra-Pulse laser work very well here, as do the newer fractional carbon-dioxide lasers such as the DOT therapy treatment. 

Another important factor in loose lower eyelid skin is the tone of the lid, itself.  In some cases, the lid is loose, and any tightening procedure such as laser resurfacing, may pull it down more.  In severe cases, the white of the eye may show beneath the iris because the lower lid has become excessively loose and/or rounded.  To correct and prevent this problem, it may be advisable to have a surgical procedure known as a canthopexy  which will lift and tighten the outer corner of the eye itself.  The canthopexy is often done at the same time as a blepharoplasty and laser resurfacing.

Pamela B. Rosen, MD
Coral Springs Plastic Surgeon
3.0 out of 5 stars 2 reviews

Treating loose skin under the eyes

+1

Skin excision may work very well for tightening up skin in the region you're describing. You might also be a candidate for a cheeklift procedure, which is completed though an incision in lower eyelid and has the advantage of being a form of mini-facelift and can also give some improvement in nasolabial fold region. Your skin, facial sturcture and personal wishes should be evaluated by a surgeon so that together you two can come up with the best treatment for you.

Deason Dunagan, MD
Huntsville Plastic Surgeon
5.0 out of 5 stars 4 reviews

Loose skin under eyes

+1

Fillers will correct hollowness along the lower lid cheek margin. It will not improve the loose lower eyelid skin.

Steven Wallach, MD
Manhattan Plastic Surgeon
4.5 out of 5 stars 18 reviews

Stop Bluffing and consider a Blepharoplasty

+1

Usually as we advance in age the eyelid skin loses its youthfulness.  Fillers are a reason nonsurgical way to improve this area.  These measures are temporary. Depending on your perspective and the result this may be a good or bad.  The best way to have a more lasting improvement is through a blepharoplasty.  Depending on the issues , a blepharoplasty can remove loose skin, aid in tightening of the skin and correction of hollowness.   Visit with several board certified plastic surgeons for opinions concerning your eyes.

Good luck.

Dr. ES

Earl Stephenson, Jr., MD, DDS
Atlanta Plastic Surgeon
5.0 out of 5 stars 9 reviews

Correction of loose skin under the eyes

+1

The only way to correct loose skin under the eyes, particularly if you have already had fillers, is to remove the excess skin with a blepharoplasty or to do laser resurfacing or peel the area. What will work best for you will require a consultation with a plastic surgeon with experience in eyelid rejuvenation.

Robert T. Buchanan, MD
Highlands Plastic Surgeon
5.0 out of 5 stars 4 reviews

Operation to correct

+1

It's not that simple. Determining the proper operation is a complicated decision making process. This can be quite straightforward or exceptionally complex. It depends on how loose your skin relative to the laxity of the eyelid.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
5.0 out of 5 stars 48 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.