What are my options for fixing my lower eyelids? (Photo)

Hi SC,
The best non-surgical treatment for the crepe skin under your eyes would be a fractionated CO2 laser treatment, I like to use Fraxel repair for this. Otherwise, the skin can be excised under local anesthesia, a skin pinch. You also appear to have thickened muscle under your lower lid. Make sure to choose your treating physician most carefully. Good luck and be well.
Dr. Persky
Encino, CA

You likely need lower blepharoplasty but more detailed evaluation is necessary to determine. See an expert.

There are several options to help improve lower eyelid concerns. One you mentioned already is blepharoplasty. This will surgically correct excess skin as well as any eye bags. Another is fillers to improve volume loss. AccuTite is a minimally invasive option which uses RF technology to tighten skin and improve eye bags. Results can be optimized by adding Morpheus8 treatments to improve overall skin tone and texture.

Your photograph demonstrates wrinkled and redundant lower eyelid skin. There are some great options for correcting this problem. These include a pinch of skin, TCA peel and CO2 laser peel. These could all be done in an office setting. The pinch of skin will remove excess skin and tighten the envelop of tissue but will not remove all the wrinkles. We often combine the pinch technique with a 35% TCA peel which will remove most of the wrinkles under the eyes. A CO2 laser peel is the most aggressive approach, but the laser can both shrink and tighten the skin removing the excess skin and tightening the the skin to eliminate the wrinkles. With both the TCA peel and the CO2 laser peel you will need ointment on your lids for one week and the skin can be pink for several months. You can use make up to hide the pinkness after one week once the skin has healed. Consulting with surgeons skilled in these techniques would be a great way to learn more about these procedures.

Most expert experienced artistic plastic surgeons have a variety of procedures, both non-surgical and surgical, at their disposal to produce excellent cosmetic results in the appropriately selected patient: temporary fillers, lasers, micro-fat grafts, and blepharoplasties. Each has benefits and drawbacks and depends on desired outcome and individual anatomy.

In a patient with your inherited anatomy, a blepharoplasty will produce the best and longest lasting cosmetic result.

Following the advice of anyone who would presume to tell you what to do without seeing photos and without taking a full medical history, examining you, feeling and assessing your tissue tone, discussing your desired outcome and fully informing you about the pros and cons of each option would not be in your best interest. Find a plastic surgeon that you are comfortable with and one that you trust and listen to his or her advice. The surgeon should be certified by the American Board of Plastic Surgery and ideally a member of the American Society for Aesthetic Plastic Surgery (ASAPS). You should discuss your concerns with that surgeon in person.

Robert Singer, MD FACS

La Jolla, California