Lower blepharoplasty or tear trough filler - which one can help me with wrinkles? (photos)

Question

I'm 42 years old, I've found Botox injection doesn't work for me anymore.

Randal Haworth, MD, FACS · Answer

Lower blepharoplasty can treat :
-Drooping lower eyelids
-Loose skin
-Deep creases
-Under-eye bags

Due to the delicate nature of the skin around the eyes, wrinkles are often a concern. Lower eyelid surgery can address some eye wrinkles by removing excess fat and tissue.

It can smooth and tighten the skin beneath the eyes, but it only targets wrinkles and creases caused by loose skin or undereye bags, and won't address other types of eye wrinkles like crow's feet, which are a series of wrinkles that form at the corners of the eyes, and vertical wrinkles between the eyes that cannot be effectively treated with either upper or lower eyelid surgery because they are caused by natural movements and expressions, rather than aging.

Based on your pictures, I think you would greatly benefit from this procedure in comparison to fillers.

Selcuk Inanli, MD · Answer

Hello! Thank you for your question.As far as I can see from the photos you have extra skin above your eyes. For this skin I can suggest you upper eyelid blepharoplasty. As for the wrinkle I recommend you fat injection to under eye area. After these procedures you have more fresh, elegant and young looking.Best Regards!

Sam Speron, MD, FACS · Answer

This is a common question. Lower eyelids may be rejuvenated with lower blepharoplasty or cosmetic eyelid surgery. Lower eyelid surgery is performed to correct eyelid wrinkles below the eyes. It is one of the first cosmetic surgeries people usually get to address features that make you look older, more tired than you feel, and may interfere with your vision. While the average age might be 30 to 50's, some patients get this done in their 20s. It really depends on your unique anatomy as well as what exactly is bothering you.

Injectables such as neuromodulators or filler as well as laser treatments can also be a tremendous benefit if you are not interested in surgery. Of course, there are also many combinations.   A mini facelift or midface lift is another great option for many people to correct eyelid wrinkles and other signs of aging around the eyelids.

I would recommend that you see a board-certified plastic surgeon in your area that is a member of both ASPS & ASAPS and performs a lot of eyelid lifts but also offers all the nonsurgical options such as injectables and laser treatments. Go over your concerns with them and make sure above all, you walk out of there with several options and an idea of the pros and cons to each of them as well as realistic expectations.

Damien Grinsell MBBS, FRACS (Plast) · Answer

Hi
I really dont think your lower lids are bad enough for a surgical solution such as a lower blepharoplasty. If antiwrinkle injections arent working any more I would advise either threading or there is a new filler in Australia which can help with facial rejuvenation rather than adding volume (Sadly AHPRA forbids me from using the name :(

Regards
Damien

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.

Zoran Potparic, MD · Answer

Based on these photos, you are a candidate for transconjuctival lower blepharoplasty. This procedure will take care of hollow cheeks, tear trough, improve dispigmentastion. Most of the procedure is done through an incision inside the eyelid; a small pinch excision of the skin leaves the scar along eyelashes. We frequently combine this procedure with pariorbital fat, micro and nano graftying, to improve overall appearance of the area. Good luck.

Jyoshid R. Balan, MBBS, MCh · Answer

Nice to get a query from you. By the photos given by you, I suggest getting fillers for under eye area along with botox for the craw's foot wrinkles.

Anish Abrol, MD · Answer

There are multiple options to address the wrinkles around your eyes. Tear trough filler is best for a volume deficiency. By adding volume, this can cause some of the wrinkles underneath your eyes to resolve. However this is not a lasting result as filler will dissolve.
You can consider a lower blepharoplasty to redrape the fat pads underneath the eyes. At the same time, skin can be excised to reduce the appearance of your wrinkles. Alternatively, a TCA peel or CO2 laser can be performed at the same time to tighten your skin.
Lastly, you can also consider a Halo laser treatment, but this may require multiple sessions.

Brooke R. Seckel, MD, FACS (retired) · Answer

Thank you for your question.

The first step would be to have Botox injection in the crows feet area most of the wrinkles that you see in your eyelids are along the sides and Botox could lessen most of the wrinkles that I see effectively.

Surgery lower blepharoplasty surgery cannot reduce wrinkles because wrinkles are caused by the contraction of the eyelid muscles.

If you see hollow dark circles under the I and excess skin and a lower eyelid blepharoplasty with arcus marginalis release fat removal fat grafting and skin pinch excision would be the best treatment if the Botox does not relieve your symptoms

Lower blepharoplasty or tear trough filler - which one can help me with wrinkles? (photos)

Answers (9)

More Eyelid Surgery Questions

Dark circles, wrinkles & uneven skin tone - would a blepharoplasty be a good option for me? (photos)

How do surgeons reverse non-incisional eyelids surgery? (Photo)

What type of blepharoplasty would address my under eye sag? (Photo)

Is it normal to have loose skin on my eyelids 4 years after upper blepharoplasty? Can I have surgery again? (Photo)

How do I make the eye on the right (the one with more upper eyelid exposure) the exact same as the one on the left? (Photo)

What is best to improve my under eye area? (Photo)

WE SEND PRETTY
EMAILS