Blepharoplasty eyelid surgery, hollowness under eyes
Doctor Answers 6
15 years after lower eyelid blepharoplasty
A non-invasive procedure such as CO2 laser resurfacing combined with cautious use of fillers could improve the crepe-like wrinkles and improve the skin texture and contour of the lower lids and tear trough. Be sure to learn the risks and benefits of each procedure prior to making a decision to proceed. Best wishes.
Lower lid hollowing
Hollow lower lids after blepharoplasty
Without photographs, it is difficult to give a precise answer. It is fantastic that you had such a nice result for a long period of time after your lower lid blepharoplasty! None of us can escape ongoing aging, unfortunately. From your description, you probably have further development of excess lower eyelid skin, which tends to be crepe-like or "crepey," along with the emergence of a flat or hollow look (typical as we age and lose fat from all parts of the face). This may be amenable to a CONSERVATIVE re-trimming of the skin, or CO2 laser re-surfacing. Also helpful, perhaps, would be Botox for the crow's feet area so that the muscle movement that tends to exacerbate and facilitate the lines when you smile could be relaxed. Injections of filler material (one of the hyaluronic acids) could be helpful in "plumping" the area so that the lines have less tendency to form. Theses fillers are not permanent, so we would expect re-emergence of the lines and less fullness over time. Injection of microparticulate fat into the lower eyelid is a more long-lasting solution, which is even more powerful when combined with the CO2 laser resurfacing to eradicate the crepey skin. The best advice is to see a board-certified plastic surgeon with extensive experience in fat transfer and facial procedures who can thoroughly examine you in person and go through the options with you. Best wishes for a beautiful result!
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Loss of lower eyelid fat
Fat removal during blepharoplasty
It's very difficult to answer your question without seeing your pictures, however I can tell you that those of us who trained after the 80's rarely remove fat from the lower eyelids, but rather reposition it, because fat removal usually makes the patient appear hollowed out over time. Dermal fillers or fat injection under the eyes may be the answer. If your original surgeon is not still in practice, please seek out a Board Certified Plastic Surgeon. Best of luck to you!