Lower lid pinch vs lower blepharoplasty? (photo)

Question

My lower eyelids have always bothered me. Even when I was a teenager I had lower eyelid crease. (Does not appear to be fat pads, just large protruding eyes) I don't smile in photos anymore because of it and I'm only 28. What type of procedure would be most appropriate for achieving smooth lower lids with facial expression.

Soheila Rostami, MD, FAAO, FAACS · Answer

you need to have fillers in the lower eyelids, plus chemical peel and neurotoxin injections of the crows feet and lower eyelids.

Kenneth Yu, MD · Answer

Hello.  Based on the photo and your age, I think a skin resurfacing procedure (either chemical peel or laser) will achieve a nice tightening of the lower lid wrinkling.  I don't recommend a lower blepharoplasty (either pinch or transconjunctival) for you at this time.  If you are serious about pursuing a procedure, make sure you find a board certified surgeon for a consultation.  Take care.

Robert L. Steely, MD, FACS · Answer

Good morning!Looking at your photos I agree that you do not have excess fat- just some thin skin that could use tightening.  I would recommend ablative laser resurfacing of your lower lids- done properly you would get great results.  You would have some downtime as the skin reepithelializes - count on about 7 to 10 days before makeup could be used.It is critical that you see a surgeon that has a lot of experience using this technique-- be sure to do your research and ask to see before and afters of their work.I hope this helps

James R. Gordon, MD, FACS, FAAO · Answer

Thank you for the question and photos. Your eyelids are not ready for either of the surgical procedures you are considering. You would have less risk and probably have improvement with Botox injections followed by Erbium Laser Skin Resurfacing. Make a consultation with an experienced board certified Oculoplastic Surgeon for evaluation. Good luck.

John Dean, MD · Answer

I think that you can achieve a significant reduction in your excess lower eyelid skin excess with a skin only (or pinch) blepharoplasty , without violating your muscle or orbital septum.  The incision should hide nicely below you lash line.

Anand G. Shah, MD · Answer

Hi there.  Please understanding that the definitive answer rests with an in-person exam and consultation.  Given your age and the overall presentation, a surgical intervention may be less indicated.  Options include Botox as well as laser resurfacing.Hope this is helpful.Regards,Dr. Shah

Barry L. Eppley, MD, DMD · Answer

For a young patient with upper lower eyelid rolls and some creepy skin, a pinch blepharoplasty may be helpful. Iy is important to remember that there is no procedure that is going to eliminate all skin wrinkles while smiling.

William Portuese, MD · Answer

A lower lid and pinch blepharoplasty is usually performed on patients over 50 years of age when there is excess skin at rest, not upon animation. At age 28, you're also not a candidate for lower eyelid blepharoplasty.  For the dynamic wrinkles of the lower lids, consider laser treatment or Botox for the crows feet

Gustavo A. Diaz, MD · Answer

Looking at your pictures is apparent that you are young but have a mild excess skin problem when you smile.A lower eyelid skin pinch surgery will help with this problem, But because of your age and the outside scar that it can produce I feel compelled to share with you my experience with resurfacing and Botox combination of the lower eyelid area. These last 2 procedures when used in combination will help in decreasing the bunching and excess skin on the lower eyelid area.Please consult your Facial/Plastic Surgeon.Hope this helsp,Dr. Gus Diaz

John A. Standefer Jr., MD, FACS · Answer

The lower eyelid muscles that close your eye and contract when you smile are attached to the skin. When the muscles contract, the skin wrinkles appear. This process progresses as the skin becomes thinner with age due to loss of collagen. Tightening the skin with a skin pinch vs tightening the skin with laser resurfacing seem to be your best options. I do not see fat pad bulging on these photos, so I agree with your observation that it does not appear to be excess fat. I do not believe that a  skin pinch by itself will give you the benefit that you desire,  I do believe that elevating the skin over the lower eyelid and re-draping the skin while tightening it may be a good alternative. Care is required since the muscle of the lower eyelid is weak naturally, and it is not strong enough to hold the lid up if there is any tension on it . Laser resurfacing is a good choice as well, as there is no incision or sutures but it takes several days to completely heal. You can wear makeup within one week however. Unless your examination shows something more than I see on the photos, fat pad removal will not be recommended.John Standefer MD

Lower lid pinch vs lower blepharoplasty? (photo)

Answers (13)

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