I have these lines in the corners of my eyes, I assume from squinting. Do I Need Eyelid Surgery? (photo)

I am so frustrated. I have these lines in the corners of my eyes, I assume from squinting. I have spent tons of money on procedures that haven't worked. My first was filler under the eyes. The doctor went in through the mouth and hit a nerve. My left eye and cheek was swollen and numb for 3 months. The second was erbium on whole face. It did nothing. The third was co2 non ablative. That also didn't work. I'm at a stand still as to what to do next. Please can someone help me?

Doctor Answers 15

Lower eyelid surgery

If pressing on your eyeball accentuates the bulges in the lower lid region, trimming of the excess fat by a surgical blepharoplasty approach should work. 

San Francisco Facial Plastic Surgeon
4.4 out of 5 stars 35 reviews

Need for Eyelid Surgery ?

Cosmetic eyelid surgery (blepharoplasty) is usually performed to correct problems such as excess, stretchy skin on the lids which can bunch together creating wrinkles, or forward bulging of fat pads in the lids.  If one has a visible depressed groove along the lower border of the lower eyelid, as your photos show, then fat can be moved into this area to fill the groove in.  It sounds as if you had an unsuccessful nonsurgical attempt to fill that groove with fillers.  If the so-called crows feet at the corners of your eyes are your main concern, then injection with botulinum toxin, such as Botox, is your best treatment as surgery will not smooth these lines.  They are caused by the repeated puckering of your skin with smiling, and so the relaxation of the muscles is the best treatment.  However, sometimes there is sagging of skin in the temple area, which can result in wrinkling of skin near the corners of your eyes, and in that case a brow lift may help smooth these lines.  Also, I do notice some fullness running horizontally just below your lower eyelashes, and this might possibly represent thickening of muscle.  This does not necessarily look bad, but if it did bother you, then surgery could reduce this area.

Richard G. Schwartz, MD
West Palm Beach Plastic Surgeon
5.0 out of 5 stars 30 reviews

Do I Need Eyelid Surgery?

No, not from the photos provided.  Eyelid Surgery would not have any affect on the "Crow's Feet".  Botox, Dysport or Xeomin injections would reduce the unwanted lines and wrinkles.  

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.6 out of 5 stars 25 reviews

Eyelid creases

Eyelid creases are caused by the muscle movement under your skin. Surgery cannot eradicate this. You can improve these areas with blepharoplasty/botox treatments and good skin care.All the best

Thomas A. Narsete, MD
Denver Plastic Surgeon
5.0 out of 5 stars 10 reviews

Do I Need Eyelid Surgery

I see a small amount of excess orbital fat that accentuates the depression in the lower inner eyelid.  This can be improved via a conservative blepharoplasty that repositions the prominent fat into the depression.  Fine wrinkles represent skin creasing caused by eyelid muscle function.  This cannot be erased but can be lessened by good skin care and by periodic peeling or laser treatments.

Philip E. Fleming, MD
Nashville Plastic Surgeon
5.0 out of 5 stars 2 reviews

Lines under the Eyes

You appear to be young but are developing old skin. Presently I would do nothing for the lines you have, as they are a normal variant. You do not want to have a blepharoplasty that removes any of the fat as some responders have suggested, as this is not your problem. Besides, as you age, any cosmetic problem that develops will be worse and harder to correct. It appears you have prominent muscle. You should not try and remodel this. You are beginning to get small crinkly lines in the skin generally and have significant dyschromia (spots) from sun damage. Treatment for this is skin rejuvenation with Hydroquinone and Retin-A (the ObagiĀ® Nu-Derm system is the best that I have found including lasers) and prevention of further sun damage using a DAILY sunscreen containing Zinc Oxide.


Robert T. Buchanan, MD
Highlands Plastic Surgeon
5.0 out of 5 stars 6 reviews

Lines under my eyes

It looks like you have a little extra fat and so I would consider a transconjuctival lower bleph with a pinch blepharoplaty followed by a Hetter's peel.This should do a lot to solve your problesm

Robert Brueck, MD
Fort Myers Plastic Surgeon
4.9 out of 5 stars 64 reviews

Do I need eyelid surgery

Actually you do not need eyelid surgery. You appear to be fairly young and this is most likely just a familial trait. It is not "excess" fat and should not be removed. However , should you decide to seek surgery, it should still not be excised. It can be repositioned through a variety of incisions either just below the eyelash or from behind the eyelid. However, both these approaches give you the risk of scarring and lower lid retraction. a new technique has been developed which is a new approach from a tiny incision lateral to the lower eyelids which minimizes this risk and also allows for tightening of the muscle for better lower lid support with less surgery than in a traditional blepharoplasty. This technique is being punlished soon and should be abailable worldwide shortly.

Fillers would be a temporary option but there have been serious issues from injections around the eyes including sudden blindness.  

Grady B. Core, MD
Birmingham Plastic Surgeon
4.6 out of 5 stars 12 reviews

Transconjuntival lower blepharoplasty

 The primary goal of  lower blepharoplasty is to remove the herniated fat  in the lower lids. There are 3 compartments of fat in the lower lid  which become puffy  when the orbital septum  becomes lax and creates puffiness. This can be removed  by a transconjunctival  approach  ( inside the lower lid). If there is any  excess skin and a small pinch technique can be performed  just below lash line and closed with tissue glue. The link below this to our blepharoplasty photo  gallery.

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 145 reviews

You need a competent Board Certified Plastic Surgeon

From those photos, it looks as if a simple transconjunctival lower lid blepharoplasty will do the trick. All of those other treatments were probably a waste of money.

William B. Rosenblatt, MD
New York Plastic Surgeon
4.2 out of 5 stars 12 reviews

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.