What Can Be Done for Crepey, Saggy Skin Under the Eyes?

I am in my 40s, with fair Irish skin. My skin looks pretty good except under my eyes- I have crepey loose skin directly under my eye when I smile. (Crows feet are minimal.) I've read that filler won't help though years ago I did get Sculptra in the hollows and thought it looked pretty good. My skin was not as crepey at that point. Can anything be done?

Doctor Answers 15

A combination of resurfacing treatments plus very conservative surgery should help.

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Without an examination, it is difficult to say for sure. If the crêpey appearance is as minimal as it sounds, you could see great results from laser resurfacing to tighten the surface of the skin and promote collagen production. Alternatively (or perhaps in addition), you may consider a very, very conservative blepharoplasty (eye lift surgery), but be sure to choose a highly qualified cosmetic surgeon with a lot of experience working on the eye area. And finally, invest in a nourishing night cream and an outstanding sunscreen and use them both religiously to further protect your skin’s firmness and elasticity.

Crepey Loose Lower Eyelids

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Crepey loose lower eyelids may be improved with surgical and nonsurgical treatments.  Depending on the individual situation chemical peels, lasers and or surgery can be performed to improve the lower eyelids.  It is recommended to be evaluated by a plastic surgeon to discuss the various options.

Craig Mezrow, MS, MD, FACS
Philadelphia Plastic Surgeon

Crepey under eye skin is very difficult

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You can use fillers, topical moisturizers, and Botox to the orbital rims as safe measures to gain some slight benefit.  Otherwise you would need lasering or surgery or both depending on your exam.  The real problem is the potential for the eyelid to pull down (ectropion) if any too much is done or if the lid is at all lax.  It may be necessary to tighten the lid (canthopexy) to minimize the risk but that can make you look "different."  So, you should see real experts and be cautious and keep your expectations conservative for safety.

Prevention and Protection

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You want to start with prevention, make sure you use a product that specifically has SPF for the eye area.  Also utilize good medical grade under eye creams daily this will help reduce the creepiness over time. Procedures such as ThermiSmooth Eyes and Exilis Ultra eye treatments can be used for treating saggy crepe skin under the eyes. These are radio frequency treatments that are comfortable and have no down time.  If the skin is saggy and has fat bulges you may want to talk to your plastic surgeon about lower eye lid surgery known as a blepharoplasty. 

Jill Hazen, DO
Princeton Plastic Surgeon
5.0 out of 5 stars 6 reviews

Periorbital rejuvenation: treatment of crepiness and loose skin

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The specific treatments depend on the degree of laxity and whether you are prepared to consider surgery. 

I would introduce retinol into your skin care regardless of the specific approach. My favorite cosmeceutical lines, Environ and ZO, have specific eye products which will be useful. Sun protection is important: use sun glasses when directly exposed. 

Where there is significant loose skin, blepharoplasty ought to be considered.

To address the issue of thin, crepe-like skin, treatment with the CO2 laser (Madonna Lift) produces good results (if there are no contra indications). The down time associated with this treatment is relatively short and a series of 3-6 monthly treatment should produce visible improvements.

Chien C. Kat, FRCS
Birmingham Plastic Surgeon
4.8 out of 5 stars 100 reviews

Crepey, Saggy Lower Eyelid Skin treatment options

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First I would address the reason for these lower lid  and crows-feet wrinkles. These type of wrinkles are often seen in patients that squint so first of all I would make sure that if you need visual correction then use glasses or contacts (if not sure, have your vision tested) and use sunglasses on bright days.                                                                                                                                                                                    Now for treatment options, other than the the frequent use of moisturizers, Retinoids like Retin-A, and sunscreens you can consider the use of fillers like Restylane and Juvederm are helpful to decide the degree of benefit from supporting the skin. If you like the effect then consider a more permanent solution like fat transfer. Secondly, a deeper TCA peel, Sciton SkinTyte laser or fractional laser treatments often help. Both fillers and resurfacing procedures are complementary and synergistic in your case. For redundant skin, a conservative skin pinch blepharoplasty may also be of benefit. A qualified board certified aesthetic surgeon will help you find the right treatment for you

What Can Be Done for Crepey, Saggy Skin Under the Eyes?

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This is a very common problem. Botox is usually the "go to" option for treatment of wrinkles related to excessive muscle movement. However, overtreatment of the area below the lower eyelid (not crow's feet) can result in temporary drooping of the lower lid. Therefore, these lines are best treated either with CO2 laser resurfacing or lower blepharoplasty. I hope this information is helpful.

Stephen Weber MD, FACS

What Can Be Done for Crepey, Saggy Skin Under the Eyes?

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Laser Resurfacing around the eyes is a great way to re-stimulate more collagen growth, smooth out crepey skin and tighten the skin.  We offer the DOT Co2 Laser.

Stuart B. Kincaid, MD, FACS (in memoriam)
Beverly Hills Plastic Surgeon

For Saggy Crepey skin under the eyes

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Although it is a challenging area to treat, there are therapeutic options to improve the appearance of loose skin and wrinkles and crepiness under the eyes. The best approach is to see a dermatologist or plastic surgeon for a consultation, and they will guide you with the ideal prioritized approach. Most likely you will benefit from retinoid and moisturizing creams which help to reduce fine lines, conservative resurfacing lasers that help to tighten skin and minimize fine wrinkles, and ultherapy that can help to tighten the skin. Good luck.

Marianna Blyumin-Karasik, MD
Davie Dermatologist

Options for excess lower eyelid skin

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Thanks for sharing your question. For redundant skin to the lower eyelid you have a few options to help tighten this area.  First a fractional CO2 laser will help treat this loose skin. Similarly a medium depth chemical peel such as Jessner's /TCA 35% will also work. Surgically a skin pinch or skin only lower lid blepharoplasty will help to remove the excess skin directly. Consult with a few board certified surgeons and dermatolgists to review your options. 

Raymond E. Lee, MD
Orange County Facial Plastic Surgeon
5.0 out of 5 stars 101 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.