Blepharoplasty Alternatives? (photo)

My 27 year old fiancé recently had a 30% TCA lower eye lid peel to reduce the amount of skin around her lower eyes that was only moderately successful. When she smiles the skin around her eyes bunches up and continues to do so after the peel. Her PS said that she wasn't a good candidate for blepharoplasty because there wasn't a significant amount of fat and that the skin pulled up could cause a "droopy" effect, pulling down her lower lid. Can anyone recommend any alternatives like lasers, etc?

Doctor Answers 2

Blepharoplasty (Eyelid Lift) Alternatives

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The alternatives to a blepharoplasty really depend on the anatomical characteristics of your eyelids.  If the eyelid skin is loose enough, then a blepharoplasty is usually needed to trim away the excess, thereby smoothing the lid.  However, certain conditions predispose to a droopy lid developing after surgery, such as lax lid tone or very prominent globes, so you do need a thorough exam to determine if you are a good candidate for an eyelid lift.  Also, excess fat bulging outward usually requires surgery to either remove or reposition the fat in order to smooth out the lid contour.  If your anatomy increases the risk of a droopy lid, then there are additional techniques to help prevent that problem.  If surgery is not indicated or too risky, then alternatives include a medium depth TCA peel, which you have referred to, to help improve fine lines on the lids.  However, I have not found the peels able to firm up loose skin that much.  A laser resurfacing may tighten the skin more than a peel.  Also, injection of fat in the lids or filler along the junction between the lid and cheek can fill in certain depressions and create an overall smoother contour for your lids.

West Palm Beach Plastic Surgeon
5.0 out of 5 stars 32 reviews

Botox can help under eye skin bunching

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A small amount of Botox in the under eye area can reduce bunching.

i agree with you plastic surgeon. The lower eyelid skin in your young fiancée is tight. Some filler may help with her natural hollows. Based on these photos,  I would not recommend lower blepharoplasty nor laser tightening.

Embrace her for the beautiful woman that she is, and enjoy your wedding!

Lisa Chipps, MD
Beverly Hills Dermatologic Surgeon

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