Wrinkles Around Eyes - Blepharoplasty vs. Restylane vs. Fat Grafting?

Dear Dr I hate these wrinkles around my eyes,on the corners and under, recently I found some folding skins on the upper eye lid and dropping the corner and lower eye lids as well. how it can be fixed without dropping more lower eye lids . 2-Do I have Ptosis condition? 3-Do I need eye lift?both eye lids belpahroplasty? 4-what about mid face lift to have fuller,younger look speciilay around eye areas? please advice with approximate cost in Torotno and L.A areas and best surgeons

Doctor Answers 6

Fillers, Botox injections, and ptosis repair.

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You have mild upper eyelid ptosis which would be nicely addressed with an internal ptosis repair.

In addition, you prominent eyes with mild cheek descent and a tear trough deformity [hollowness between eyelids and cheek. This could be nicely addressed with fillers [Restylane or Juviderm]. The fine lines around the eyes [crow's feet] can be addressed with  Botox.

Pricing can vary from surgeon to surgeon. A good resource to find Oculoplastic surgeons is ASOPRS.org. You can search by city and or state.

In LA area, Drs Steinsapir and Goldberg have a lot of experience with periocular fillers/botox as well as ptosis repair. In Toronto, Dr James H. Oestreicher, MD, and his colleagues are excellent.  You can find their contact information on the website I listed above.

Good luck



Seattle Oculoplastic Surgeon
5.0 out of 5 stars 42 reviews

Eyelid ptosis and hollowness

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Your two most obvious problems are upper eyelid ptosis (droopy) and hollowness.  The ptosis is also causing you to raise your brows to see better, which in effect unveils the upper eyelid hollows.  Ptosis surgery would lift your eyelids, lower your brows, and help cover up the upper eyelid hollows.  Additional surgical and nonsurgical options are available, depending on your exam.  You should consult an oculoplastic surgeon.

Dr Taban

Mehryar (Ray) Taban, MD, FACS
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 91 reviews

Wrinkles around the eyes

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Thank you for submitting your photos - they are very helpful.

You are young and tend to have some hollows around your eyes.  I would as much as possible attempt to avoid surgery and use less invasive ways to improve your eyelid concerns.  I am sure that fillers (ie. Restylane) and Botox (in a variety of areas around the eyes) can significantly help without cutting.

The one area that does need surgery is to correct your ptosis.  However, if you are an appropriate candidate this can probably be performed without an external skin incs ion (so no scar).

As surgeons we often tend to go right to cutting.  Often times patients also are self directed in this way.  There is a place for on-surgical intervention and our job is to provide this information.

Be careful in how you proceed and get at least three consultations from specialists in eyelid surgery before making your decision on what to do.


Guy Massry, MD
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 54 reviews

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Eye lid wrinkling, fat grafting and fillers

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I think, as you can see from the answers here, that you have a lot of potential options.  You are quite young and a conservative approach is likely the best way to start.  It is almost impossible to tell you exactly what you need until you have had a full evaluation.  Photos, while helpful in some cases, can be deceiving.  I would highly recommend seeing a Plastic Surgeon who can do that evaluation and give you a set of options that will fit your needs, desires and budget

Brian Windle, MD
Kirkland Plastic Surgeon
4.9 out of 5 stars 64 reviews

Best Treatment for Wrinkles Around the Eyes

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Hi Elie,

Non-invasive methods (Fraxel repair, Restylane, Botox) for you eyelid wrinkle concerns would be best.  Surgery for ptosis and mid-face lift.  You can also achieve improvement in your midface, neck, and peri-orbital areas with Ultherapy, ultrasound treatment that lifts and tightens non-invasively.  Cost varies depending upon the procedure as well as the individual surgeon.  Do choose your treating physician most carefully.  Good luck and be well.

Dr. P

Michael A. Persky, MD
Encino Facial Plastic Surgeon
4.8 out of 5 stars 39 reviews

Filler and Botox

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I would recommend Juvederm in the tear trough and latera orbital shelf and some Botox in the crows' feet area. Alternatively you would benefit from a midfacelift in which case you would not need the filler. Yes you have very mild ptosis so you can wait on that.

Peter T. Truong, MD
Fresno Oculoplastic Surgeon
4.9 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.