Mixto or Eyelid Surgery for Tired Looking Eyes?

I am 38 and my biggest concern is with my eyes. I have a tired look. I don't have lots of fat under my eyes, not too much wrinkling but some. I just look tired. My upper lids are starting to droop. I have some wrinkles on face and neck as well. I have fairly sensitive skin and a red tone. Will MiXto help me with my under eyes and wrinkles or should I just pay more money and get eyelid surgery? Even if I still did procedures, I'd want to fill my laugh lines. I'm trying to get a picture on here soon to show my facial skin.

Doctor Answers 8

Eyelid surgery is the most predictable way of really improving your tired appearance

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While fractionated lasers like Mixto can improve skin darkness and mild wrinkling, they really cannot address true upper eyelid skin drooping/excess. For that, an upper blepharoplasty is the easiest, most comfortable, and most predictable way to get visible and aesthetically pleasing results.

For lower eyelid wrinkling, with no real bulging fat, that can be treated surgically, with a very judicious amount of skin excision, or with full-field (ie, not fractionated) skin resurfacing. I generally prefer the full-field resurfacing for lower eyelid wrinkles, as the results are good and the lash line incision and its attendant risks are skipped.

Finally, based on your age and description of your upper eyelids, I would suspect the upper eyelid issue may not be a true "eyelid" issue, and might instead be an early drooping brow. If you like the way your upper lids look in the mirror when you gently lift up on the temple end of your brow, that may actually be what you need over upper eyelid surgery or the Mixto as far as your upper eyelids are concerned.

Saint Louis Facial Plastic Surgeon
5.0 out of 5 stars 230 reviews

MiXto vs Surgery for Aging Eyes

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Again of the eyes, especially the "tired" look, is usually the result of descent of the upper eyelids. Brow ptosis or descent pushes down on the upper lids causes dermatochelasis or extra skin in the upper lids. In addition the lid margin can descend due to the added weight and gradual loss of levator muscle tone. Your lower lids don't sound bad other then descent of your cheeks.

So with few wrinkles it sounds like you probably need an upper lid lift with either an internal brow pexy or a formal endoscopic brow lift. The lower lids may need either a midface lift or volume enhancement with fat. MiXto or fractional CO2 may help with improvement of skin tone of the lower lids.

Careful what you look for!

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Hi Tony

The Mixto laser before and after pictures are impressive. However, recognize that a couple of before and after pictures is no guarantee that the procedure for you will produce the dramatic results seen in a before and after picture on a website. Generally to fufill the promise of minimal down time and procedure comfort fractional C02 lasers the energy setting is reduced to the point where these treatments can be expected to improve skin quality in most patients but not necessary produce the type of dramatic results depicted in these photos. The key is that they is no such thing as a free lunch.

Should you have eyelid surgery as an alernative? Perhaps. However, I think the best option is to find a surgeon you trust and makes sense to you. See what they recommend. If their recommendations make sense to you then you will know you are on the right track.

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

Sculptra Is Best For Non-Surgical Eyelid Rejuvenation

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Without photos, I cannot give you many specifics. However, I have had terrific results with Sculptra for filling the upper cheeks. Volumizing the upper cheeks will probably minimize the appearance of bags. Moreover, there is good evidence that Sculptra will increase the apparent thickness of the skin, and will provide improvement in skin texture.

I have been unimpressed with many of the fractional resurfacing lasers, like the MiXto. They work great for removing freckles, and they do soften wrinkles. However, I have not seen dramatic improvements.

Eyelid surgery is great for removing excess skin, fat, or muscle. At 38, I doubt that these are your problems.

Michael C. Pickart, MD
Ventura Plastic Surgeon

Eyelid surgery, mixto, tired eyes, blepharoplasty

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Dear Tony, eyelid surgery and Mixto will yeild different results in regards to the skin and the shape of your eyelids. Mixto will help with the skin texture, fine wrinkles and perhaps some color change- if there is sun damage.

Eyelid surgery will help with the skin- lines, loosenes, the puffing fat and the shaping of the lower and upper eyelids...... the result may be more dramatic than Mixto alone.

So the choice will depend on the features of your eyes and the changes you want to make.

With Warm Regards,

Trevor M Born MD

Trevor M. Born, MD
Toronto Plastic Surgeon
4.9 out of 5 stars 126 reviews

Eyelid surgery if done correctly can have dramatic effects in improving your tired appearance

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Eyelid surgery if done correctly can have dramatic effects in improving your tired appearance. Unfortunately, there are no creams or fillers that can plump up the skin enough to take away the puffiness or drooping of the lids. One thing you can do at night time that often helps is wet your lower eyelids with water and then cover with vaseline and for several hours when you wake up the wrinkles will be gone. However, surgery done correctly so that it is not over done can last you from 12 to 15 years around the eyelids so it may be something to consider. Without pictures it is hard to say what would benefit you the most. I hope this information helps.

Scott Trimas, MD
Jacksonville Facial Plastic Surgeon
5.0 out of 5 stars 20 reviews

Eyelid surgery for tired eyes

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The goal of upper eyelid surgery is to remove excess skin and a small amount of fat and puffiness that is present on the medial or nasal side of the eyelids. The goal on the lower eyelid surgery is primarily to remove excess fat and puffiness, which creates the tired look, and occasionally remove some excess skin if over age 50.

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 157 reviews

Laser vs surgery for eyelid treatment

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Laser smooths wrinkles in the skin while surgery removes or redistributes skin, muscle, and/or fat. Sometimes surgery and laser are performed simultaneously.  Which procedure you choose all depends on what you need to accomplish.

Brian Biesman, MD
Nashville Oculoplastic Surgeon
4.8 out of 5 stars 43 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.