Under Eye Wrinkle Treatment with Blepharoplasty

Thank you for the great question. In short, it really depends on the location and quantity of the wrinkles. Dynamic wrinkles lateral to the eye ("crow's feet") can be softened with Botox. Once these are more permanent, laser resurfacing using a fractional CO2 laser is my preferred treatment. In the area directly under the eye, it is common to have some thin or crepey skin. If there is a significant amount of extra skin, a lower eyelid lift is likely a better choice. This can address the skin excess as well as any fat herniation that is present. Lastly, lower eyelid surgery can be combined with laser procedures for a more complete rejuvenation. Best of luck moving forward!

Thank you for your question.  There are several ways to address skin wrinkling at the time of blepharoplasty.  Laser skin resurfacing and chemical peels can both be highly effective.  In my experience, a modified skin resurfacing  procedure provides the best outcomes safely.  I do not find fractional ablative lasers like Fraxel as helpful as some others.  Best of luck.

The fine wrinkles under the eyes can be treated with a few different techniques depending on the severity of the issue. For large deep folds I use a blepharoplasty with a lateral muscle suspension and skin excision. For the fine wrinkles that many people get you are right that a resurfacing technique is best. In my hands the best results are with a fractional CO2 laser. That is pretty standard and is replacing chemical peels in most practices these days. To put the cherry on top I often advocate for some volume in the area as well. The cause of the wrinkles both loss of volume and skin aging. So it is best to treat both issues. Fat is my favorite. The new fillers also do a decent  job but are temporary. 

Hope this helps. 

Best of luck,

DrC

It's not unusual for patients to develop lower eyelid wrinkles following normal facial aging. When this situation arises, a variety of treatment options are available to treat this condition. These include trichloracetic acid peels, the Frexel CO2 laser and lower eyelid blepharoplasty. The ultimate procedure chosen will depend upon the patient's anatomic findings and aesthetic goals.If you're considering treatment of lower eyelid aging, it's important to consult a board certified plastic surgeon. This surgeon should be able to formulate a treatment plan that addresses your concerns.

Both procedures are great options, but I generally prefer combining CO2 resurfacing with a blepharoplasty, simply because the the laser goes deeper and yields the short-term benefit of textural improvement (fine lines and wrinkles), with the long-term benefit of skin firming.  I recommend having a wrinkle reducing treatment done the same time as your blepharoplasty so that you have one downtime.  Speak with your surgeon and share your desires to ensure his/her recommendation will exceed your expectation.

Both TCS peel and Fraxel CO2 laser are effective at treating the lower lids in conjunction with your upper eyelid blepharoplasty. The TCA peel treats more mild cases and has faster healing time, but care is required to ensure it does not get into the eyes. The CO2 laser can be used for more prominent wrinkles and can treat up to the lash line. One laser you did not mention is the Erbium laser. It gives great results with short recovery time and is very safe.