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

Question

Dear RS doctors, I'm 32 and have fair skin that's overall good except for my undereye area. One problem is the lumpiness after a fat graft (that can be mitigated with fillers somewhat), but lately my greatest has been progressive wrinkling/crepeyness. As you can see, there's all of that - also visible when relaxed/static. Pelleve hasn't really done anything. What is your advice? I'm considering Plasmage, PRP, even a lower bleph. Am I too young for it? What are the risks? Many thanks!

Jason Emer, MD · Answer

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

Prashant Murugkar, MD · Answer

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

Thomas Copperman, MD · Answer

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.

Francis (Frank) William Rieger, MD (retired) · Answer

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

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

Answers (4)

Answer: What can I do for my lower lid laxity?

Answer: What can I do for my lower lid laxity?

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Everything you need to know about Eyelid Surgery

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

Answers (4)

Answer: What can I do for my lower lid laxity?

Answer: What can I do for my lower lid laxity?

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Recommended reading

Everything you need to know about Eyelid Surgery

Our mission is to create a world where every investment in modern beauty is Worth It.