What to do for under eye laxity? (Photo)

Question

I have a lot of laxity around my eyes. I get Botox which helps a bit and it was recommended to get an upper blepharoplasty to take care of sagging but wondering what else can be done for under eye extra skin and laxity. I don't have extra fat or bags so don't necessarily want under eye bleph but have read about eye punch surgery...could that help? What about lasers maybe?

Sam Speron, MD, FACS · Answer

Hello and thank you for your question and pictures!  Upper eyelid hooding can be corrected with blepharoplasty or cosmetic eyelid surgery. It is one of the first cosmetic surgeries people usually get. While the average age might be 30 to 50's, some patients get this done in their 20s. It really depends on your unique anatomy as well as what exactly is bothering you.

Botox injections as well as laser treatments can also be a tremendous benefit if you are not interested in surgery. Of course, there are also many combinations.  Lasers and Botox will help you achieve a reduction in wrinkles and create a firmer and more rejuvenated look.

I would recommend that you see a board-certified plastic surgeon in your area that is a member of both ASPS & ASAPS and performs a lot of eyelid lifts but also offers all the nonsurgical options such as injectables and laser treatments. Go over your concerns with them and make sure above all, you walk out of there with several options and an idea of the pros and cons to each of them as well as realistic expectations.

I hope this helps answer your question. If it does, please take a moment to up vote this answer on the “respond” button on the top right.

Nima Shemirani, MD · Answer

Hi @Beautiful904188! Upper eyelid hooding can be treated with an upper eyelid blepharoplasty. Botox can help reduce wrinkles. I would recommend consulting a board certified plastic surgeon to further address your concerns. Best of luck with your journey!

Jonathan Kulbersh, MD · Answer

Thank you for your question and photo. Adding laser resurfacing to your Botox treatments may help improve skin laxity in this area while reducing fine lines and wrinkles. This treatment option uses a laser to remove the outermost layer of skin to reveal the newer layer below, resulting in a refreshed and rejuvenated appearance. I recommend scheduling an in-person consultation with an experienced, board-certified facial plastic surgeon. They will be able to review your Botox injection results and determine what additional treatment options may help you achieve your desired results.

Jason Emer, MD · Answer

For puffiness and sagging under the eyes, we often use Renuvion helium plasma radiofrequency energy to achieve incredible results and take years off of your appearance. Combining RF energy and cool helium plasma, the signs of aging (wrinkles, pigmentation, skin laxity) are improved in a ‘Nonsurgical Eyelid Lift.' The focused heating tightens and peels the upper layers of skin with extreme precision, leaving the surrounding area undamaged, smoothing and tightening the periorbital skin, and improving the overall skin quality around the eyes. It's an aggressive treatment, and the recovery time is longer than with other nonsurgical procedures, but the results can be life-changing.​ See an expert to determine if this is the best solution for you. Best, Dr. Emer

James R. Gordon, MD, FACS, FAAO · Answer

Thank you for sharing your question and posting your photo. Injection of Botox followed by laser resurfacing could improve your skin tone and wrinkles. Make an appointment with an oculoplastic surgeon for comprehensive evaluation and guidance. Good luck!

Andrew Campbell, MD · Answer

The best way to treat lower eyelid laxity is to simply remove the excess skin. If someone has a very small amount of excess skin, a laser can tighten it and make it look quite good. When someone has enough excess skin that they really need a pinch to remove the excess, then a laser really can't do much, you need to remove the skin. This is typically done in the office using local anesthetic. The scar us a few millimeters below the lash line and heals incredibly well. The sutures are removed in 3-4 days. The upper lids can be treated at the same time.

Andrew Campbell, M.D.
Facial Rejuvenation Specialist
Quintessa

Andrew Campbell, M.D.
Facial Rejuvenation Specialist
Quintessa

Nelson Lee Novick, MD · Answer

The Ten Minute Eyelift, a minimally invasive, nonsurgical procedure typicfally engendering little significant downtime can work well for reducing upper eyelid laxity. Following local anesthesia, the lid laxity is reduced via the use of light electrocautery. I have been performing this procedure for several decades for this purpose with gratifying results. Even performed it on myself about fifteen years back. You would be wise to consult with an experienced, board certified cosmetic dermatologist. Best of luck.

Yao Wang, MD · Answer

Hi there, upper eyelid blepharoplasty can easily help with extra upper eyelid skin. It doesn't appear that you have excess lower eyelid skin. You can try some lasers/energy based device or chemical peels to "iron out" out the wrinkles. I would recommend going to an oculoplastic surgeon near you to discuss the options based your exam. Hope this helps!

Camille Cash, MD · Answer

There are several options to improve under eye laxity, depending on the degree.  Lower blepharoplasty surgically addresses the under excess skin and results in a smoother under eye appearance.  Laser resurfacing can improve texture as well as some mild laxity.  For general skin health and maintenance treatments such as Morpheus8 can improve overall skin tone and texture.  Visit with a board certified plastic surgeon near you to learn more.

Vibha Gambhir, MD · Answer

I would highly recommend CO2 laser resurfacing for the whole face with focus around the eyes.  A consultation would be needed to decide depth and down time but this is great for helping fine lines and wrinkles.

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