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