I'm 20 Years Old and I Was Wondering What I Could Do to Tighten the Skin Under my Eyes? (photo)

I have really bad sagging skin under my eyes, and really bad wrinkles, and whenever I smile the wrinkles get worse because I have so much loose skin!! I just don't look my age and its depressing. Please help!

Doctor Answers 4

Fillers vs fat repositioning

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The anatomic change that you show is a very common hereditary type eyelid problem. This can be addressed by "fat repositioning" lower eyelid blepharoplasty as a more permanent solution.

Alternatively, if you do not want [or cannot afford] surgery, temporary fillers [juvederm, restylane, boletero] can provide you nice results, thought more temporary.

Seattle Oculoplastic Surgeon
5.0 out of 5 stars 42 reviews

Be very careful what you decide to do here.

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You have darker skin which generally does not do well with many types of laser procedures or chemical agents.  There is a substantial risk of hypo or hyper-pigmentation.  The fullness in the lower eyelid is the classic fullness that arcus marginalis surgery is performed for.  Filler might also be a reasonable alternative for you.  Often there is not a right or wrong about how to proceed.  It comes down to what you are comfortable with.

Kenneth D. Steinsapir, MD
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 26 reviews

Minimal non-surgical treatments since you are still young

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It is unusual for a 20-year-old to have loose skin. Loose skin is an age-related change. It can be present in younger people if there is a lot of eye rubbing, allergies, sinus problems, skin issues and other problems that can accelerate the skin into getting thinner. I also noticed in your photos that you have an area of puffiness under your eyes. Based on those photos, I think you have something called lower eyelid fat prolapse.

If you notice that your eyes are puffy on pretty regular basis then this is caused by fat behind the eyelid that pushes forward. The most common factor responsible for this is genetics. If there are other factors such as sinuses and allergies, it tends to make the fat pockets a little more swollen. If this is also associated with eye rubbing then it can make the skin thinner.

In my practice, we do a step by step evaluation of the elements that can make the eyes look like they’re tired and addressing the wrinkles is part of that evaluation. At 20 years old, this is the time of your life when your skin is going to be at its best. You may want to consider some minimal intervention such as the use of topical creams and moisturizers to help protect your skin. You also may want to see a specialist to get an evaluation why the skin is thin. Your darker skin type tends to hold very well unless there are environmental allergies and other factors.

To summarize my perception of your skin issue, you may want to be conservative about any topical treatment for the wrinkles. In our practice, we actually have a skin care line and one of our popular products is the Eye Rescue cream. It’s a combination of moisturizers and some active ingredients that’s well tolerated by our patients. There are also a lot of eye creams in the market that you may want try first.  Eye cream is one of the key elements of helping skin that appears wrinkled. Also, take a look at your eyes in the morning and compare them in the evening. See if it tends to be puffy more often than not. If it does, then you may want to consider some type of aesthetic procedure. 20 is a little young for such a problem, but with modern technology and techniques it’s something that can be addressed.  I hope that was helpful, and thank you for your question.

Amiya Prasad, MD
New York Oculoplastic Surgeon
4.4 out of 5 stars 80 reviews

Lower eyelid blepharoplasty may help tighten your lids

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Wrinkles below the eyes can be removed by simple blepharoplasty or can be decreased by Botox injections. The use of Botox to reduce wrinkles is temporarily and may require repeat injections every 3-6 months. Since you are young, one has to be careful not to be too aggressive in whatever cosmetic procedure is undertaken to take away your natural appearance. From your pictures, it appears that you may have some mild ptosis of both of your upper eyelids which could be corrected giving you even more visible eyes.

Imtiaz A. Chaudhry, MD, PhD, FACS
Houston Oculoplastic Surgeon

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.