Blepharoplasty or fraxel laser? (photos)

Question

I've always had puffy eyes but they're getting considerably worse with age. I also have droopy eyelids (which I glue the skin into my socket to lift) and very lined bags especially when I smile. I'm 32 and desperate to have them sorted as hate looking in the mirror :( Please could you recommend the most effective and cost effective treatment you would recommend Many thanks :)

James R. Gordon, MD, FACS, FAAO · Answer

Thank you for sharing your problems. Blepharoplasty and laser skin resurfacing combined is the best treatment for your particular problems. The blepharoplasty will remove the bags, while the laser will improve the wrinkles and skin texture. See an experienced doctor who commonly performs both techniques.Good luck,

Kenneth Yu, MD · Answer

Hello.  It's always a bit challenging to give a comprehensive answer based on photos, but I do see some of the things that are bothering you.  On frontal view, I don't appreciate much fat pseudoherniation, and I think some sort of skin resurfacing (either CO2 laser or chemical peel) can give you a subtle improvement.  It also looks like you have tear trough deformities on 2nd photo.  Options include fillers or blepharoplasty to improve the contour.  The best thing is to see a board certified surgeon for good in office exam and further discussion of your options.  Good luck.

John J. Martin, Jr., MD · Answer

You have a few options - just remember that you can never get rid of all the lines!  can only improve them.  You could try some HA filler such as restylane to add some volume below the prolapsed fat pads.   This with some laser resurfacing should work well to tighten the skin and make it look smoother.  Another option is a lower lid blepharoplasty with fat repositioning.  Could also do the laser resurfacing with that.

Jeffrey S. Rosenthal, MD · Answer

You are on the younger side of patients who have lid surgery; but, it is not uncommon to perform a blepharoplasty in someone of your age group.  When there is a combination of extra lid skin, upper and lower lids, combined with bulging fat pockets, above and below, a blepharoplasty is the most suitable procedure.  Laser or fillers will not address these issues.  Seek out a surgeon who has experience with the blepharoplasty procedure.  You wish to look refreshed and natural not tight or pulled.

Sean R. Weiss, MD, FACS · Answer

The appearance of the lower eyelids can be improved in a number of ways.  Given your age, you would likely have a very nice response to a combination of good skin care, laser resurfacing, and injectable fillers. An in-person evaluation would be needed to confirm that you are a candidate for these things.  It is also possible. but unlikely that surgery would be recommended at this time.  Best regards.

Vasdev Rai, MD · Answer

Fraxels do not do it. You need surgery. Surgery is expensive but also is cost effective since it works.

William Portuese, MD · Answer

From the very limited photographs, it appears there may be excess skin on the upper lids and fatty deposits in the lower lids. The primary goal for upper eyelid surgery is to remove excess skin creating the hooded or tired look. A small amount of fat is also removed from the upper lids when necessary. The primary goal for lower eye lid surgery is to remove the bags creating the puffy look. The fat is removed from an incision on the inside of the eyelids  known as a trans-conjunctival approach. If there is excess skin present, small pinch technique can be used. The amount of skin removed on the lower lids is determined at rest, not upon animation. For more information and many examples, please see the video and  the link below

Blepharoplasty or fraxel laser? (photos)

Answers (7)

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