Extra Baggy Skin After Blepharoplasty

I'm in tears every day due to a Blepharoplasty surgery and Laser Resurfacing. I am only 36 and looking back, there was nothing wrong with my eyes. Now I do. I have extra baggy skin, extra folding sunken eyes and wrinkles which I never had before and not sure how to repair this. I probably should never had the surgery in the first place. My eyes were fine. It's not even a year later and now I have a huge problem. I am seeking help...can someone address me?

Doctor Answers 12

Extra skin can be removed.

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Extra baggy skin on the upper lids can be addressed with removal through the old incision. The lower eyelid baggy skin can be removed through a subciliary incision located right at the lash line, which conservatively removes any skin without changing the shape of the eyelid. Sunken eyes are very difficult to deal with post blepharoplasty surgery, but fat injections can be attempted deep into the orbital area to try to augment that area

Seattle Facial Plastic Surgeon
4.8 out of 5 stars 157 reviews

Don't rush into surgery.

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This is a great forum for seeking answers and advice. However, without pictures (preferably before and after) it is very difficult for us to give you any advice or comments. Eyelid surgery, especially lower lid surgery, is very difficult and should not be rushed into lightly. If you have concerns, you should return to your original surgeon or seek a second opinion. Good luck.

You need to consult with a good plastic surgeon

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I am not sure exactly what you had done, but I have an idea about the problems you are experiencing. Photos would help.

Since you are about a year out from your initial procedue, you should either see the surgeon who performed the procedure and express your concerns, or seek a second opinion. You will be evaluated for the need for additional procedures including fillers, perhaps a chemical peel, laser resurfacing, or a secondary blepharoplasty. Perhaps no further surgery is indicated. Stop beating yourself up, and get an opinion so you can make your plans.

Revision lower eyelid surgery

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Revision lower eyelid surgery is a very difficult area. You should consult with board certified plastic surgeons on your options.

You mentioned your eyes looked fine before surgery, yet you had surgery. This underscores that surgery should not be performed unless a problem is actually there; I do not believe in "prophylactic surgery". Any surgery, however apparently small, carries with it risk.

For your revision, the surgical plan should be clear and reasonable, and tailored to your problems.

Brent Moelleken, MD
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 194 reviews

Need pictures of you

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To really make any reasonable suggestions, we would need to see some pictures of what you look like. There are many options for you including Restylane to the lower lids if too much fat was revmoved leaving you sunken and with loose wrinkled skin. There are many outstanding doctors in Toronto and you should go to the very best Plastic Surgeon there and ask their opinion. Good luck!

Extra baggy skin after blepharoplasty requires volume replacement and skin tightening

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I am very sorry to see and hear of your frustration. You can be helped and have improved appearance of your lower eyelids.

Your first step is to seek consultation with two board certified plastic surgeons who specialize in eyelid surgery. Visit http://www.surgery.org to find doctors in your area.

Call the offices and ask:

  • Does the doctor specialize or have a lot of experience in correcting bad blepharoplasty results
  • pick two doctors
  • ask the doctor to show photos of results of eyelid surgery he has done
  • trust your gut feeling about the doctor and staff
  • see if recommendations of both doctors are sililar and make sense to you
  • consult friends who have had surgery by these doctors-were they satisfied
  • ask your primary care doctor about the doctors reputation

Generally there are several options for correcting the problems that show in your photo:

  • Volume Replacement to fill the hollow and plump the skin-I use composite fat grafts placed under direct vision through a small transconjunctival incision through the inside of the lower eyelid-I DO NOT recommend fat injections or filler injections-they often become lumpy and will add lumps to the host of problems that you already have
  • Skin Tightening- Fractional ablative Erbium laser resurfacing in combination with volume replacement is , in my opinion the safest option-done by an expert you will see good results. Skin excision can be done, but this requires a lid incision which can weaken eyelid support and create a sad eyed look-another additional problem that you do not want
  • Consider Botox-Botox can reduce wrinkle producing contraction of the eyelid muscles which causes crows feet and adds to wrinkling of lower eyelid skin. this would be a third option which I would only do after the first two options are completed.

Loss of elasticity

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The reasons for your wrinkles can be many; genetics, smoking, pollution, sun, overresection of fat leading to a hollow look. In any case, you have excess skin (lasers do a lousy job of removing skin) that should be removed surgically. As for the future, you need to address the things that make you age prematurely and treat them on a daily basis. Stop smoking, retin-a, sunblock, anti-oxidants, chemical peels.

Robert M. Freund, MD
New York Plastic Surgeon
4.8 out of 5 stars 34 reviews

Several options for extra baggy skin after Blepharoplasty

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Lower blepharoplasty continues to be one the challenges to get consistently excellent results due to several factors. We have developed an approach to blepharoplasty that considers all the factors that affect the aging lower eyes. In short, the main options include skin excision (also called pinch excsion) ,skin tightening via laser or peeling, and volume replacement via microstructural fat grafting or dermal fillers.

Richard D. Gentile, MD
Youngstown Facial Plastic Surgeon
4.5 out of 5 stars 45 reviews

Blepharoplasty Problems

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I don't have photographs of your eyes, so it is difficult to give you specific advice. That being said, I am assuming from your comments that you had lower eyelid surgery (Blepharoplasty). This surgery is one of the more difficult operations. The general trend in lower blepharoplasty is toward conservation of the lower eyelid skin, preservation of lower orbital fat, avoiding tension on the lower lid, performing a canthopexy or canthoplasty if needed, and filling the tear-trough depression.

I would suggest that you have a consultation with an experienced Board Certified Plastic Surgeon or other specialist who is comfortable with revisions (facial plastic surgeon, oculo plastic surgeon). It is important that your surgeon is up-to-date with current trends in Blepharoplasty and is very comfortable reconstructing your lower eyelids.

Daniel Reichner, MD
Newport Beach Plastic Surgeon
4.9 out of 5 stars 50 reviews

Seek an oculoplastic surgeon with Blepharoplasty correction experience

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Dear Intears:

With all due respect to my general plastic surgery colleagues on this forum, there is only one cosmetic surgery specialty with the largest body of experiencing fixing unsatisfactory eyelid surgery, and that is a fellowship-trained oculoplastic surgeon. This is an individual who is a board certified ophthalmologist, who has completed a fellowship approved by the American Society of Ophthalmic Plastic and Reconstructive Surgery, and has been elected as a fellow to this society.

However, this is not sufficient. That surgeon also has to devote a significant portion of their practice to addressing and fixing unsatisfactory eyelid surgery. Unfortunately, there are only a handful of us who cater to addressing these issues. It may be necessary for you to travel to see one of us for an appropriate second opinion. Look for this level of training and don't simply accept the advice of a general plastic surgeon or a facial plastic surgeon. Unforunately, these types of problems do require this level of special attention.

Good luck with your search for the right specialist.

Kenneth D. Steinsapir, MD
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 26 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.