Suggestions on How to Improve Lower Bleph Results? (photo)

Two years post lower bleph surgery. Hollowness, sunken in, darkness and discoloration(upper and lower), dents, wrinkling and crepiness when I smile. My dermo is suggesting lasering to get rid of darkness and wrinkles. I'm not sure my lids can take another surgical type insult. I'm almost 60. Any suggestions?

Doctor Answers 6

How to improve lower lower lid results.

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As you see from the variety I answers above this is a complicated issue and I agree with most of the responses above. However, fillers are temporary. Lasers would be helpful but would not replace the lost volume.I would recommend a lower lid muscle lift through a tiny lateral incision with pearl fat grafts to replace the volume that was removed.  This will lift and tighten the lid and restore the volume .  

Birmingham Plastic Surgeon
4.6 out of 5 stars 13 reviews

This is a tough question to really answer without a personal consultation.

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Fillers are brilliant if you have adequate skin integrity to hide the service.  This can be very treatment dependent.  I often perform a phenol chemical peel to help lower eyelids like yours and this sets the stage for then placing fillers if additional help is needed.  I think that fractionated CO2 is potentially helpful but it may be somewhat disappointing as well.

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

Lower lid issue

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Gentle insertion of filer material along the lower lid region may help with some of the hollowness you are experiencing. An exam in person is really key to determine this.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Hollow appearance after lower lid blepharoplasty treated with fillers.

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Aggressive removal of lower lid fat can lead to a hollowed out appearance. Temporary solution is the use of fillers.

Revision of blepharoplasty

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It appears that you had a reduction blepharoplasty meaning that fat was removed and skin was removed but nothing was done to restore the youthful volume to the peri-orbital area.  The bulges you have may be residual fat or folds of the underlying muscle.  A correction may include a re-elevation of the skin flap, a suspension of the orbicularis muscle, repositioning of any residual fat to fill in the hollowed out areas and elevation of the lateral malar fat pad to fill in the lateral hollow.  

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 20 reviews

Options to help lower eyelids

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It difficult to tell from your picture, but it appears that there may be a small amount of residual fat under the medial portion of both eyes.  If this is the case, this issue could be surgically addressed.  The wrinkling and creepiness can be addressed with lasering, as you mentioned, or a minor surgical procedure can be done to remove a small strip of skin below your eyelashes to help.  It's also possible that a filler, such as Restylane, could help but the results would be temporary.  

Michael I. Echavez, MD
San Francisco Facial Plastic Surgeon
4.5 out of 5 stars 18 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.