Under Eye Wrinkles and Hallowness, is Blepharosplasty the Right Solution for my Under Eye Problem? (photo)

I'm mid 40's .Eye creams and botox don't work at all ! Friends who did fillers failed to get good results and most reviews here don't recommend fillers.

Doctor Answers 9

Eyelud surgery

I think you are a good candidate for lower eyelid surgery.  You have puffiness and need the extra fat removed surgically.  Injectables are not a good solution for your situation.

San Diego Plastic Surgeon
5.0 out of 5 stars 27 reviews

Under eye rejuvenation

Hiya, your under eye are can be addressed using the following techniques..

1- fillers, either fat transfer or temporary fillers such as a hyaluronic acid material

2- transconjuctival lower belpharoplasty

3- filler with laser treatment

once again, an examination in person is required as your pictures only tell part of your story... good luck!

Dilip D. Madnani, MD, FACS
New York Facial Plastic Surgeon
4.9 out of 5 stars 89 reviews

Under Eye Wrinkles and Hallowness, is Blepharosplasty the Right Solution for my Under Eye Problem?

If you are very conservative than use of fillers would be best. But they ONLY last a few months, so repeAt visits are needed. Next if you desire a more permanent result than consider transconjunctival blepharoplasty for fat removal and adding that fat as a grab to the trough. 

Darryl J. Blinski, MD
Miami Plastic Surgeon
4.6 out of 5 stars 173 reviews

Under Eye Wrinkles and Hallowness, is Blepharosplasty the Right Solution for my Under Eye Problem?

               Fillers or fat grafting to the tear troughs would be reasonable options.  Fat grafting will produce a longer lasting result, but fat transfer is not uniformly reliable.   Fat grafting may need a second session for full improvement.  Find a plastic surgeon with ELITE credentials who performs hundreds of fat transfer procedures each year.  Then look at the plastic surgeon's website before and after photo galleries to get a sense of who can deliver the results.  Kenneth Hughes, MD Los Angeles, CA

Kenneth B. Hughes, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 492 reviews

Fat grafting for tear trough volumization

You need to be examined to make a decision about this - but your upgaze photo does not show a substantial increase in 'under eye' puffiness, leading me to conclude that perhaps fat grafting alone would be a good solution for you.

Scott C. Sattler, MD, FACS
Seattle Plastic Surgeon
4.8 out of 5 stars 65 reviews

Hallows under the eyes.

If fillers are not working i would consider blepharoplasty with transposition of the eyelid fat into the hallowed area.....

Cynthia Boxrud, MD
Santa Monica Oculoplastic Surgeon
5.0 out of 5 stars 6 reviews

Lower eyelid options

Fillers are a valid option for improving under eye hollows/dark circles. Another more permanent option would be lower blepharoplasty with fat transposition (the puffy area is due to fat; that fat is brought down to fill the hollowness underneath it).  See an oculoplastic surgeon for evaluation.

Mehryar (Ray) Taban, MD, FACS
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 72 reviews

Under eye treatment

There are 3 main issues to address when evaluating the lower lid. The quality and quantity of the lower eyelid skin, prominence of the lower lid fat pads and volume loss in the region at the junction of the lower lid and upper cheek called the tear trough.

The ideal treatment is based on the presence of these 3 factors and the degree to which they are present. Although your photos are helpful they can not replace a formal evaluation.

From the photos I see some prominence of the medial lower lid fat pads and some volume loss in the tear trough area. The skin quality looks good.

I would discuss fillers to the tear trough, possible removal of the medial fat pads of the lower lid and possibly a resurfacing of the lower lid skin or ultherapy.

Seek out a board certified plastic surgeon in your area to evaluate you and help guide your decision making process. I hope this was helpful and good luck.

Robert W. Kessler, MD, FACS
Corona Del Mar Plastic Surgeon
5.0 out of 5 stars 129 reviews

Fat Grafts Could Help

Thank you for your pictures.  You might consider fat grafting to help improve the lower eyelid/cheek junction.

Dr. ES

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.