Can a Lower Eye Lift Work on Deep Creases Close to the Lash Line?

I've always had a set of two deep set creases under both my eyes. They're so bad they can be seen from a few feet away. I also can't wear eye make up becuase it settles down into the lines. I'm only in my 20's and don't have any other wrinkles like crows feet in the same area. I'm wanting to know if they can be safley removed by surgery or with fillers.

Doctor Answers 9

Eyelid Surgery

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For creases close to the lash line, Fillers are not my first choice.  A lower lid blepharoplasty can remove a few mm of skin and tighten this area up, and the scar is nearly invisible.  This has worked very well for us.

Lower Lid Creases Can be Made Better

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Without a photo or examination, it is not possible to determine the best treatment.

As young as you are, surgery is not a likely option, while using BOTOX in tiny doses to weaken the muscle at the lid crease may improve the problem.

Treatment options for lower eyelid lines

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Botox may work to help smooth the lines at the lower lid.  Surgical treatment is not indicated for this issue, and is especially not indicated in an individual in her 20's.  If the lines were due to skin aging, it might help to use DOT therapy fractional CO2 laser resurfacing.  However, this sort of problem is usually addressed starting in the late 30s or early 40s. Hyaluronic acid fillers such as Juvederm or Restylane are useful if the groove is lower down on the lid in an area known as the tear trough.  If the line is right below the lashes, these fillers are not indicated, as the problem is due to a roll of muscle tissue which may actually look better if properly treated with Botox.

Pamela B. Rosen, MD
Coral Springs Plastic Surgeon

Lower lid surgery for creases

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I would agree that surgery at your age and with your description of issue is likely to be a mistake.  I suspect that the line you see is actually a crease formed from a normal attachment to the lower lid skin that helps fold the lid when you look down.  So in simple terms, it might be there for a reason.  However it can be camoflaged with either filler or botox, or even smoothed with a form of resurfacing.  The correct answer depends on what is truly driving that crease. 

Botox is probably the most straightforward solution, as fillers close to the lash line have the potential to remain visible and lumpy.  Botox is an elegant way to deal with obicularis hypertrophy when used in precise, low doses in the hands of an experienced surgeon.

Problems with lower lid creases

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Prominent lower lid creases in someone as young as yourself are likely due to the action of the orbicularis muscle, the muscle that closes your eye. A small amount of Botox, carefully placed, can soften this line.

Katherine A. Lane, MD
South Burlington Oculoplastic Surgeon
5.0 out of 5 stars 13 reviews

Photos would be helpful

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Please provide photos so that we can give a more informed opinion regarding your condition. As mentioned, depending on the specific problem [muscle, skin, fat] different options are available:  botox, fillers, surgery.

seattleface com

A.J. Amadi, MD
Seattle Oculoplastic Surgeon
5.0 out of 5 stars 41 reviews

A photo would be very helpful here.

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Given that you are in your twenties, lower eyelid surgery will be a disaster for you.  Please do not do this to yourself.  Threaded Restylane filler or a small bit of BOTOX is a much better option.  Please read on my website what can go wrong with lower eyelid surgery and try to save yourself from being wrecked.

Kenneth D. Steinsapir, MD
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 26 reviews

Lower Lid Creases

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Without pictures or examining you in person, it is impossible to give you specific advice.  However, yes, there are a variety of techniques to treat lower lid creases depending on the etiology.  As stated, if it is muscular, then a Botox injection may help soften the crease.  If it is hollowness or loose skin, then a surgical procedure may be more appropriate.  Please be careful with letting people inject any fillers into your lower lids.


Good Luck.

Lower lid crease

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You might be describing prominent orbicularis muscle (aka  orbicularis hypertrophy). If so, botox is the best treatment for that.  If you are describing hollowness in the tear trough area, then fillers are good option.

Dr Taban

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.