Help with excessively loose, old-looking skin under eyes. Suggestions? (photo)

I'm 42 and have had loose skin and hollows under my eyes for so many years that I stopped smiling years ago. I've gone to a few plastic surgeons but no two same opinions. I'd prefer something more "permanent" rather than spending $ routinely on injections. I'd also like to reduce the age spots. I've even tried to combat this from the inside out by diet. I wear a hat with glasses and a sun mask. I feel like I look like an 80-year-old. I'm an endurance runner and keep myself on the thin side.

Doctor Answers 4

You need volume, and removal of some of the excess skin.

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If you want a more permanent solution, you should consider a fat transfer to the lower eyelid. This will help to fill in the hollow and decrease he wrinkles. Hopefully you will have some fat even though you are thin. It looks like you have a fair amount of skin, so a pinch blepharoplasty could be done. I would also recommend some laser resurfacing to help improve the skin texture.

Coral Gables Oculoplastic Surgeon
5.0 out of 5 stars 31 reviews

Volume and skin resurfacing

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Hello! Volume is the fix for the under eye hollows. Fillers are the safest route, but fat can be used to augment this region as well. A skin ablative procedure either with lasers or a chemical peel will help with fine lines and eliminate the dark spots. However, Botox is still required to MAINTAIN, as the squinting caused by muscle contractions will put wrinkles back in this area. Sunscreen is also vital. Good luck!

Catherine Winslow, MD
Indianapolis Facial Plastic Surgeon
4.6 out of 5 stars 44 reviews

Under eye hollows and loose skin

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Hollowness under the eyes and loss of skin elasticity both have an affect on the the appearance in this are. Tightening up the skin with a pinch skin blepharoplasty and repositioning some of the orbital fat and/or adding fat from elsewhere can improve the appearance. Laser resurfacing can also be beneficial, but won't treat the hollows.

Matheson A. Harris, MD
Salt Lake City Oculoplastic Surgeon
5.0 out of 5 stars 6 reviews

Fat injections and blepharoplasty

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If you presented to my practice I would recommend fat transfer to the cheek and lower periorbital region followed by lower blepharoplasty.  I would remove skin only by performing a pinch blepharoplasty.  The procedure is performed under local anesthesia with a 7 day recovery.  Good luck in your rejuvenation efforts.

Jeffrey Marvel, MD
Nashville Facial Plastic Surgeon
4.6 out of 5 stars 56 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.