How to fix sagging skin around eyes? (Photo)

Question

Are there any non surgical things that can be done to fix this sagging drooping skin around my eyes when I smile? I am 39, I use medical grade skin care and do regular face treatments including morpheus8, halo, chemical peels, etc. I typically do not do Botox around my eyes as I feel it deadens my expressions.

Michelle Lee, MD · Answer

Great question! The skin on our eyes is so thin that it will always be one of the first areas to show signs of aging. That being said, the best nonsurgical treatments would be anything aimed at thickening the skin. The plasma pen, or "fibroblast", treatment is becoming increasingly popular for this area and is highly recommended for those not yet ready for surgical intervention. However it is essential to consider skin tone and the risk of hyperpigmentation for the plasma pen treatment–not everyone is a candidate. Hope this helps! Keep up the great skin care!

Nima Shemirani, MD · Answer

Hi @MrsMidwest. Thank you for sharing your photo. A non-surgical option would be c02 laser skin resurfacing.

Best of luck,

Nima

Jason Emer, MD · Answer

The eye area needs significant combinations to get improvement. Lasers like erbium, co2, halo, profractional/contour, or Fraxel can all be used to build collagen long term. Plasma pen is a newer less invasive option but will take many treatments and require proper skincare. Plasma Pen is focused electrical plasma energy to tighten skin, producing small columns of energy just above the skin, allowing the skin to tighten to help improve wrinkles. This area will have 3-5 days of small “dots” that will then scab and peel, then the skin will tighter and brighter after. Numerous treatments are needed over lasers where only one or two give a bigger result, but more downtime. After plasma pen you NEED peels 2 weeks like later Cosmelan, enlighten or aerify, see emeragecosmetics (link). At home derma rolling should be started weekly even after plasma pen or lasers to further increase collagen, see emeragecosmetics AERIFY x anteagemd stem cell ampules. To properly heal you need light Stim red LED, EmerageSkin refit face, refit eye; AnteageMD serum, silagen silicone gel, jan Marini bioshield, EmerageSkin enzymatic polish, and EmerageSkin hyla b and AOX, and Sente dermal repair. Otherwise there is EXTREME risk of pigmentation issues and “dots” in the treatment area. at home peels like cosmelan, enlighten and aerify along with dermarolling (AERIFY emerageskin roller with Anteage MD ampules) should be started now regardless for antiaging, sun damage, and wrinkle prevention. There are many things you can do to treat under eye hollows and dark circles. A surgical option to remove skin and/or fat will such as eyelid blepharoplasty with or without fat pad repositioning (if doing lower eyelid surgery) will be the best long term. There are many things you can do to treat under eye hollows and dark circles without surgery. Non invasive less downtime options such as fillers, lasers, microneedling/PRP, cosmelan peels, and microneedling RF like Fractora, PiXel8 or morpheus can all help give some improvement. Accutite can often be used or stronger lasers like erbium or co2 spot treatment can tighten the skin and give very quick improvement in wrinkles and texture. I suggest you get a formal consultation to see what is best for you and your goals. Best, Dr. Emer.

Marc Polacco, MD · Answer

Thank you for your question. A "non-surgical" option would be laser resurfacing. This serves to tighten the skin and promote collagen remodeling. CO2 or Erbium require some downtime though, so be sure to ask your surgeon about this. All the best.
-Dr. P

Scott Trimas, MD · Answer

You can consider a laser resurfacing procedure to tighten up the skin around the eyelid area. Another options would be to do a minor skin pinch to just remove the loose skin which can easily be done under local anesthesia. I would seek consultation with a board certified facial plastic surgeon in your area.

Michael A. Persky, MD · Answer

Hi Mrs MW,
I would recommend a fractionated CO2 laser around your eyes and expertly placed dysport.  Make sure that your choose your treating physician most carefully based on their experience, skill, knowledge, training, and natural artistic vision.   Good luck and be well.
Michael Persky, MD
Encino, CA

Bilgen Katipoglu Erenoglu, MD · Answer

Hi, MrsMidwest. Thank you for your question and photo.
Although there are many non-surgical treatments towards upper eyelid skin sagging, the best results can be obtained by surgery (blepharoplasty). When I inspect your picture I can see the excessive skin, especially more hanging on the side. Seeking a non-surgical way may cost time and money, as none of them can give satisfying results as surgery. Besides, the scar in blepharoplasty is usually not easily visible and we are lucky about the scar of the eyelids. Combining this local-anesthesia operation with a fractional laser will give the most satisfying results.

Akshay Sanan, MD, FACS · Answer

Dear MrsMidwest,
Thanks for your question and uploading your photo. It appears in this photo you are smiling and you have a strong orbicularis muscle. When the muscle contracts, it pulls on the skin and that causes wrinkles and with time and aging, the skin starts to sag. You have tried all the non surgical treatments including skin tightening morpheus 8 and skin resurfacing halo and chemical peels. Botox would help you a lot because it weakens the muscle and thus the skin won't wrinkle as much. At some point you'll have to approach surgery to achieve your goals. An upper bleph will improve the skin excess of your upper eyelid. A lower bleph skin pinch will remove a sliver of skin to tighten your lower eyelid skin. I would also suggest a sliver of muscle to be removed as you clearly have strong muscle which is also likely redundant. I hope this helps.
All the best,Dr. Sanan, MDAkshay Sanan MD Facial Plastic SurgeryLos Angeles, CA

Darryl J. Blinski, MD · Answer

Based on the 1 posted photo I recommend crows feet Botox injections with lateral temple lift. Under eyes use of HA fillers with micro Botox injections. Best to virtual consult with...

How to fix sagging skin around eyes? (Photo)

Answers (9)

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