Under eyes look terrible after facelift - what can I do to fix this problem? (photos)

Greetings Margaret Elaine:Your concern here is very evident based on the photos. Without full face photos visible it is not easy to say whether or not the facelift contributed to the appearance but I doubt it. The power of most facelifts lies in improving jowls and neck bands. That being said, certain facelifts are better at improving the midface and lower lid area: the extended deep plane facelift releases the (zygomaticofacial) ligaments that limit upward mobility of lower facial tissue into the midface. By recruiting volume to the midface and lower eyelids, the extended deep plane typically does a better job or improving the aesthetic of the lower eyelid-midface continuum.
With that being said, you have 3 main issues contributing to your complaint on lower eyelid appearance: 1) Skin quality issue with wrinkles in the native eyelid skin, this is very common2) Upper and lateral cheek volume deficiency3) Festoons aka secondary lower eyelid bags that are related to the anatomy of the ligaments in the midface. These are challenging to treat.
In my experience, here are are the most effective things that could be done to improve your issues while maintaining safety and a natural look:1) Lower eyelid blepharoplasty with some component of skin excision, I prefer the skin pinch2) Skin resurfacing, most effective with a laser given the depth of the wrinkles3) Volume replacement, my preferred source is your own fat.
You will be in the best of hands if you choose an eyelid specialist for the above. Some facelift surgeons are great at eyelids and some are not. Given the response of your facelift surgeon, you may want to seek an opinion form an Oculofacial Plastic Surgery Specialist here. You can find one in your area at the ASOPRS website.
Best,
DBS

Based on your very cropped photographs it looks like the problem is with your lower eyelids and not the face. Often, surgery to fix one thing can make another problem more evident, but, this one is an easy - in the office fix for the most part.

For unique cases where a variety of modalities could be used to treat the condition, I would suggest an in person or virtual consultation to develop a custom and effective treatment plan. It is difficult to precisely define the best option without collecting the same information. I suggest reaching out to an expert for a consultation with surgical and non-surgical methods to get a comprehensive option. Best, Dr. Emer.

An examination of you would be helpful in order to give you the best advice, but there may be several options to improve your under eye area. One potential option would be surgery to tighten the skin under your eyes. It may be possible to improve the area without surgery as well. CO2 laser resurfacing of the area could produce some tightening and radio frequency micro needling is another potential option. The device that I use for this is called Morpheus8.

From the photos provided, I understand your concern. Since the upper cheek is a very important support for the under-eye region, any volume deficit in this area can result in hollows, crepeyness, etc. under the eyes. The skillful, experienced use of a robust HA filler for the cheek region can not only help to create a more oval, heart-shaped face, but can help to improve the infraorbital region. If still necessary, a low viscosity, cohesive, malleable HA filler can then be used further smooth the transition between the upper cheek and the lower lid region. Finally, a series of in-office superficial peels coupled with the at-home use of topical retinoids and alpha hydroxy acid creams can go a long way to further smoothing and blending these regions. You would be wise to consult with an experieinced board certified cosmetic dermatologist who can help with each of these approaches. Best of luck.

Hello! Thank you for your question.As far as I can see from the photos you have extra saggy skin under your area and lots of wrinkles. For get rid of this image and gain more fresh, young looking I recommend you lower eyelid blepharoplasty and fat injection to under eye area. If you can provide photos with better lighting, from the side of your face and 1 meter away I would be able to make a proper evaluation.Best Regards!

I'm sorry to hear that you're not happy with the results of your facelift, particularly the appearance under your eyes. It's understandable that you want to address this issue and find a solution.

Firstly, it's important to communicate your concerns clearly to your doctor and express that you are not satisfied with the outcome. You can ask for a second opinion from another qualified plastic surgeon to get a fresh perspective and determine whether corrective action is necessary.

A facelift revision/ lower blepharoplasty could be good options to treat this issue.

It's important to have realistic expectations and understand that revision surgery can be more challenging than the initial procedure. Additionally, there may be additional costs associated with revision surgery that should be discussed with your surgeon.

Ultimately, the best course of action will depend on the specific issue and your individual circumstances. I recommend discussing your concerns in detail with your surgeon and seeking a second opinion from another qualified plastic surgeon to determine the best course of action for you.

I hope this helps,
best of luck !