What is your advice for treating wrinkles/extra skin under eyes via lower blepharoplasty, fillers or plasmage? (Photo)

Botox can be used to improve wrinkles around the eye. Deeper wrinkles need a combination approach with Botox and lasers, microneedling/prp and fillers. I recommend getting a formal evaluation with a cosmetic dermatologist. Best, Dr. Emer

hi, I think you are too young for a blepharoplasty, I think the best answer for your problem is dermal fillers with or without pre-tarsal botox injections (if required) hope this helps warm regards Dr Prashant Murugkar

I can see the fine lines in the lower eyelids you are referring to. Usually these respond best to laser tightening treatments rather than a surgical blepharoplasty. There are also allergic conditions and other skin conditions that can give a crepiness like appearance to the lower eyelid skin. Consultation with a physician (dermatologist or oculoplastic surgeon) would be helpful to elucidate what is going on and figure out what treatment is best. 

I am not a strong believer in using fillers to the lower lids, whether this is with a restylane product or fat.  You now have some experience with fat filler and I believe that it doesn't always give the results that we expect.  Perhaps a local peel procedure, either with a chemical or a laser, might be a consideration.  Even though you are young you still could consider a lower lid blepharoplasty.  This certainly can still give you a good result.   House a very competent Plastic Surgeon and ask for a thorough evaluation to help with making this decision.Good luck to you!Frank Rieger M.D. Tampa Plastic Surgeon