Would lower blepharoplasty be effective for excess skin?

Question

Hello, Would a lower blepharoplasty procedure be effective in removing excess skin? I was told that Botox cannot be injected in the tear trough area, and that filler would work better to correct the problem. I recently had a conservative amount of Bellafill placed in that area with no results. Please see photo. Thanks in advance.

William Portuese, MD · Answer

The primary goal for a lower blepharoplasty procedure is to remove the fat bags creating the puffy look in the lower lids.  The secondary goal is to remove any excess skin at rest (not upon animation) on the lower lids.  It is very important to be conservative on the amount of skin removal of the lower lids.

Douglas M. Stevens, MD · Answer

That is correct, that botox is typically not used in the tear trough area. I love Bellafill in for the lower eye hollows, but I do think that a lower lid blepharoplasty would be the best option based on this photo.

David A. Dreyfuss, MD · Answer

Thank you for your question.  Micro Botox and fillers are a great answer for people to improve the appearance of the lower eyelid laxity.  However, it is not a long term result and visits every 3-4 months are necessary to maintain the improvement.  If you are a good medical candidate and see a qualified and Board Certified Plastic Surgeon, you would have a tremendous result.  Surgery is relatively simple, with minimal downtime.  It can be done under local anesthesia or with mild sedation.  A small incision is created just below the lashes, while the fatty puffiness is modified and the extra skin removed.  I think you would have an excellent result that would last many years and create a more youthful and rested appearance to your overall eyes and face.

Robert Singer, MD · Answer

Most expert experienced artistic plastic surgeons have a variety of procedures, both non-surgical and surgical, at their disposal to produce excellent cosmetic results in the appropriately selected patient: temporary fillers, micro-fat grafts, and blepharoplasties.  Each has benefits and drawbacks and depends on desired outcome and individual anatomy.

In a patient with your inherited anatomy, a blepharoplasty will produce the best and longest lasting cosmetic result.

Following the advice of anyone who would presume to tell you what to do without taking a full medical history, examining you, feeling and assessing your tissue tone, discussing your desired outcome and fully informing you about the pros and cons of each option would not be in your best interest. Find a plastic surgeon that you are comfortable with and one that you trust and listen to his or her advice. The surgeon should be certified by the American Board of Plastic Surgery and ideally a member of the American Society for Aesthetic Plastic Surgery (ASAPS). You should discuss your concerns with that surgeon in person.

Robert Singer, MD FACS

La Jolla, California

Would lower blepharoplasty be effective for excess skin?

Answers (4)

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