What can be done about the loose skin around my eyes? How much would it cost? (Photos)

I don't want to look like I had plastic surgery. I'm 49 years old. Healthy. Physically fit. Smoke 2 packs a day. Drink about 4 beers a day.

Doctor Answers 3

CO2 Laser

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I have great success using CO2 laser to the lower lid skin. It provides excellent tightening
of the loose wrinkled skin without creating a plastic surgery look.

Redding Oculoplastic Surgeon
5.0 out of 5 stars 4 reviews

Eyelid Wrinkles/Bags -- Restylane or Belotero, Clear+Brilliant/Fraxel, Eclipse Micropen/PRP, Viva/Intensif, Botox/Dysport/Xeomin

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this needs either laser/peel alone or a combination of skin removal and laser treatment.  Please see an expert.  Best, Dr. Emer.

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.8 out of 5 stars 207 reviews

There are some options for dealing with loose skin on the lower eyelids

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The good news is that there are a few options available to help the loose skin on your lower eyelids.  We'll have to keep our discussion general here, though, because the specific options that are best for your individual case require a physical exam to determine.  Your images help give us a general idea of the problem, but there are limited angles, the lighting isn't perfect, and we have no ability to touch or move your tissues around to better understand the problem.  The first thing I have to mention, though, is that I would be remiss if I didn't recommend that you stop smoking before doing anything to your eyelids.  I know this is much easier said than done, but the two things you need to know are that smoking is one of the fastest ways to accelerate the aging process of your skin, and smoking delays healing of tissues, such that anything you do to your eyelids will be at risk of healing problems and scar issues.  Having said that, it appears as though your main issue is one of skin laxity, and probably some laxity of the underlying muscle as well.  You do not appear to have a big problem with fatty bulges, or "bags" under your eyes.  The one question I have is how good the tone in your eyelid is?  What I mean by this is how easily does your eyelid pull away from the eyeball, how far does it go, and how quickly does it "snap back" when the traction is released?  These things are important too, because they guide us as to what to do for the loose skin and how "gently" versus "aggressively" we can do it.  You never want to simply tighten loose skin on the lower eyelid, especially if the entire lower eyelid tone is loose, because then you run the risk of pulling the eyelid down permanently.  In these cases we often will also anchor the support structures of the lower eyelid to the bone in addition to removing loose and excess skin.  Sometimes, if we don't want to perform actual surgery, we can simply focus on tightening up the skin from the outside using one or more measures in combination, including topical skin products like retinols, chemical peels, or laser treatments.  These are very effective at producing modest to very good results without having to undergo surgery.  Again, though, if you are still smoking and undergo these procedures, you may be just sabotaging your own efforts, and at best wasting your money, and at worst subjecting yourself to intolerable risk.  In the end, the best procedure(s) for you will be determined by a well trained, experienced board certified plastic surgeon, facial plastic surgeon, or occuloplastic surgeon who can fully evaluate both your goals as well as your tissues and anatomy and come up with a rational plane to recommend to you.  Best of luck.

Joseph L. Grzeskiewicz, MD
San Diego Plastic Surgeon

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.