Still Have Folds of Skin Under Eyes 30 Days After Eyelid Surgery (photo)

When my eyes are at rest, they look OK, though not much improved from before. When I smile, I still get folds of skin under my eyes, not just wrinkle lines. I had both trans-conjunct and outer lid incision sx. Did my Doc not tighten me enough? He says he couldn't tighten me further without eye problems, and that laser would be the next step. I'm pretty disappointed I spent 2k to look pretty much the same, if not worse, since with fat removed, the wrinkles and folds show more. Will this improve

Doctor Answers 1

Skin folds after lower blepharoplasty

The surgery you had done aims to make the lower eyelids look smooth "at rest".  When you smile, you rely on the elasticity of your skin, the hydration of your skin, and the underlying fullness of the fat and other tissues to prevent the wrinkling you are now noticing.  Some of us feel that fat should not be removed from the lower lids for precisely the reason you are pointing out to all of us.  A full eyelid is a youthful eyelid.  The attachment of the midfacial (cheek) supporting ligaments also need to be evaluated (I can not comment on them from your photo).  Ideally, the doctor will review these issues as part of your preoperative consultation, and ideally the patient will also bring up all his/her concerns before the surgery.  As we all know, try as we might, that doesn't always happen, or maybe the discussion took place, but not so much that it "sunk in".

At this point, all these concerns should be evaluated, and realistic expectations discussed so that you and your surgeon can map out a plan to best achieve your goals.  Laser may help improve your skin elasticity, but that may or may not be adequate.

Good luck.

Providence Oculoplastic Surgeon
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