Treating Dynamic Under Eye Wrinkles After Lower Eye Lift and Fat Removal

I want to minimize or eliminate the wrinkles under my eyes. I have always had wrinkles and bags under my eyes from birth. I had a lower eye lift in my late 20's and the doctor removed fat pockets and did a bit of tightening I think.

I wasn't satisfied with the results and I think perhaps I have more lines because of the fat removal. What would be the possible treatments for me? They are dynamic wrinkles because the move when I smile. Thanks for your kind attention.

Doctor Answers 3

Treating bunchy lower lid skin

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There are patients like you who have very active muscles around the eyes and who squint vigorously from smiling and the sun. When you are smiling it looks like there is a ton of extra skin. This is deceptive however and the true skin excess can only be determined at rest. At rest, there is much less extra. Additionally, even if you remove skin or laser it the muscle will re-create this "look" over time because you can't remove the muscle without losing vital eye closure function. Finally, if you try to aggressively remove the skin, you will pull down the lid unless you tighten the lid into the bone laterally (canthopexy) and make your eye narrower or asian looking.

Treating Lower Lid Smiling Wrinkles

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The wrinkles you are bothered by are caused by several converging mechanisms. Loose skin / sun damaged skin with excessive active lower lid muscle.

There are no totally reliable treatments for your problem and the solutions would depend on your preferences and risk acceptance as well as depending on how your lower lid looks at rest (laxity, position).

In my opinion, your best option is lower lid kin tightening and rejuvenation (provided there is lid support) with Sciton Erbium PROFRACTIONAL which allows a GRADUAL approach with minimal down time. It is a much safer technique than the CO2 based Fraxel. This technique can be combined with other modalities offered by this laser such as the MicroLaser Peel to give you a great result. It

I am SURE that you can find a competent Plastic surgeon / Dermatologist with a Sciton Profile our Joule in your area.

Dr. P. Aldea

Peter A. Aldea, MD
Memphis Plastic Surgeon

There is no effective treatment for the dynamic wrinkles under your eyes.

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The roll of wrinkled skin that forms in your lower eyelids with smiling (orbicularis roll), is a difficult problem to treat. It's the result of the contraction of your lower eyelid orbicularis muscles, and I am not aware of any solutions. Further surgery should certainly be avoided. I have tried BOTOX many times to this area and have been disappointed by the lack of response.

I hope this is helpful for you.

Eric M. Joseph, MD
West Orange Facial Plastic Surgeon
4.9 out of 5 stars 429 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.