I've had upper and lower blepharoplasty. I am left with loose wrinkly skin. I have had a peel, microdermabrasion, as well as Botox. What other treatments can I try to get rid of this wrinkly skin?
Treatments for Wrinkly Skin After Upper and Lower Blepharoplasty?
Doctor Answers (13)
Loose skin after blepharoplasty
When upper eyelid skin is crepey, peels or retinoids usually help, but it sounds as though you have already tried those. If there is little more skin that can be removed, it may be a problem that can be minimized but not eliminated. No doubt you have been assessed for drooping of the brow as well, which can contribute to eyelid skin excess, particularly on the sides.
For the lower eyelids, if loose skin is present, it may be possible to perform a cheeklift to tighten the skin. I know many doctors talk about skin pinches, but I do not like the resulting eye shape when the tightened skin, sometimes in a subtle, sometimes less than suble fashion, pulls down on the lower eyelid, altering its shape.
Therefore we typically support the corner of the eye, not just with a canthopexy but with a cheeklift plus canthopexy, if indeed these are warranted.
You may want to talk to your surgeon about these options.
Fractional Erbium Ablative Laser Resurfacing can improve wrinkly skin after upper and lower blepharoplasty
Excess wrinkly or 'crepey" skin left after upper and lower blepharoplasty is a very frustrating problem.
The most conservative and effective treatment is laser resurfacing of the eyelid skin.
The eyelid skin is very thin and CO2 laser resurfacing can be too powerful for the eyelids if power settings are not reduced.
Today, newer Fractional 2940 Erbium laser Resurfacing can be safely done on eyelid skin to remove wrinkles and toighten the skin.
While secondary surgery is certainly possible, the laser is a simple non-surgical option.
Excess skin should be conservatively removed
Wrinkly skin can be removed conservatively on the lower lids by taking a small pinch out at the lower lash line and closing it with tissue glue or soluble stitches. The excess wrinkling skin on the upper lids is very difficult to remove. You have to be very conservative on upper eyelid skin so that you can still close your eyelids after the surgery.
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I can only assume you're referring to the lower lids. One of the most difficult decisions a surgeon has to make when doing a lower lid blepharoplasty is how much skin to remove. Most of us have seen the horrendous results then too much skin is taken. So to be on the safe side most of us follow the surgical rule of "take less now and go back later to take more if you have to." This is likely what your surgeon did-a good decision. But since the excess that wasn't taken can't be corrected by any other mean than you'll have to have it surgically removed.
The only other possibility would be CO2 ablative laser resurfacing which may really help to tighten the skin and create significant rejuvenation.
Clinical exam and follow up is needed
Give it some time first. There are so many options available, but they must be individualized to you. Get an advice from a board certified plastic surgeon before you try more treatments.
Wrinkly textured skin may improve with some lasers
Lisa in SA:
You mention having a number of eyelid procedures. As other comments suggest, we would not want you to have more done too soon after the other treatments. Discuss this subject with your surgeon before you go further.
One of the discussions I have with eyelid blepharoplasty patients pre-op is to try and separate the elements of skin looseness and of skin texture problems that we will be treating. Blepharoplasty removes loose skin and tightens. Eyelids cannot be made as tight as, for example, cheek skin during a facelift. Eyelids need to be able to move and are more delicate. Making them too tight with surgery can cause problems.
Texture irregularities can remain after blepharoplasty, and need different treatments than tightening. Peels and microdermabrasion are both possible ways to improve skin surface texture. Moderate depth laser treatments are another possibility. You should be aware that surgical and medical treatments may not be able to give you smooth eyelid skin. Be careful not to do too much.
Don't rush into more procedures
Whenever you have surgery around your eye, it is best to be very patient before embarking on additional procedures/surgeries. The tissues are the eye are very sensitive and very thin. Giver your lids time to heal. If you still have continued issues with loose skin, you may want to try laser resurfacing, acid peels or a simple pinch skin excision. However, it may be impossible to get rid of all of your excess skin without causing more problems - lid retraction. So, please be careful and seek out expert consultation. Good luck.
Without photos/exam, this is just a primer on what you can do. First, the skin will tend to tighten for about a year or so after the surgery. Failing that, other peels may help, Coblation, various lasers. The more aggressive the treatment however, the greater the risk of complications of lower lid disfunction. Proceed with caution, and ask questions.
Active FX is a good option for tightening eyelid skin
CO2 laser such as Active FX can be beneficial in further tightening loose skin on your upper and lower lids. It will be important to coordinate the timing of it with the other procedures you already had, to minimize the risks.
Active FX can be done on upper and lower lids. Micridermabrasion might not be the best procedure for the delicate eyelid skin tissues and might damage it further and even compromise your vision. so I would recommend staying away from it.
Consider laser resurfacing for wrinkly skin after Blepharoplasty
In addition to chemical peels, another alternative exists in laser resurfacing. The current range of laser choices minimizes downtime and provides a very predictable healing scenario. This is by building collagen along the treated area. Sometimes several treatments are necessary and would be typically separated by a month or more.
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.