Eye Bunching after SMAS lift. Is there anything that can help soften these?

Question

I got a SMAS lift 4.5 years ago & got severe eye bunching only when I smile. I also had under eye filler 6 years ago (vobella) that I can still see the lumps under the left eye. I do Botox & micro needling with prp every 3 months & have done C02 twice & nothing helps. Have seen several surgeons & they all say there is no fix for this. I hate smiling and always hide behind sunglasses. Is there anything that can help soften these?! I'm in OC, CA so please let me know if you can help me!

Thomas A. Mustoe, MD, FACS · Answer

You have some minor lateral hooding and skin excess and the wrinkling in spite of aggressive treatments is a challenging problem. I have had meaningful improvement with a temporal browlift combined with elevation of the skin over the orbicularis muscle.  The improvement would  not be complete but significant. The approach woukd require partially opening the facelift incision and a temple incision.  The recovery would be about 10 days.

John Michael Thomassen, MD · Answer

A temporal cheek lift will smooth out these lines.  It can be done in the office under local anesthesia.  I would also recommend a conservative lower lid pinch to remove improve the bunching right under your lower lid.

Sam Naficy, MD, FACS · Answer

Part of this could be due to the fact that you may need a brow lift. The proper vector of a facelift is upward so if there is droop of the brow and forehead and it is not corrected it can result in some level of bunching after the vertical face lift. Part of this bunching is due to collagen loss of the skin around your eyes so a deep laser resurfacing would also help. Lastly doing a maintenance level of Botox injections around the eye will also help.

Connie Hiers, MD, FACS · Answer

A small amount of Botox injected all over the area would minimize the lines when you smile. Your filler of 6 years ago is gone.

Darryl J. Blinski, MD · Answer

Based on your nice post of photos and seeing you’ve tried other treatments, I would recommend the end under local anesthesia combined with Ylift. 10,000 $15,000 range. Best virtual consult with.

Eye Bunching after SMAS lift. Is there anything that can help soften these?

Answers (5)

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