wrinkles eyes and eyebags. Will a blepharoplasty or what could be a good and possibly final solution? thank you (photo)

Hi, i would like to get an advice about my eyes, im 42, lot of wrinkles under my eyes and crows feet plus eyebags, skin quite thin and sensitive. 

Doctor Answers 14

Lower Lid ideas

I saw your question on Real Self about the lower eyelids. I think the lower lid laser option would probably be best for the fine lines--I don't think you require any surgical approach at this time. A little Botox works very well also in addition.  

Eyebags and Wrinkles

Hi crudelia74

Thanks for your question. There are a few options available, both surgical and non surgical.

PRP treatment is proven to be extremely useful in addressing the concerns bought about by the ageing process which can lead to changes in skin texture, firmness, radiance, volume, flexibility and wrinkle formation. PRP can also address the dark areas under the eyes.

Wrinkles, creases and lines in these areas can be treated by filling the skin with a specially formulated gel ‘filler’. This is injected into or under the dermis (the deepest layer of the skin), pushing up and flattening the crease or wrinkle.

Lower eyelid surgery aims to address the bags under the eyes. Excess skin and removal or reshaping of the fat smooth’s the contour between the lower eyelid and the cheeks. Your cosmetic surgeon will assess if the procedure can be performed under local anaesthetic.

Make sure you research your options really well and find a qualified and experienced surgeon.

Amir Nakhdjevani, MBBS, MRCS, FRCS (Plast)
London Plastic Surgeon
5.0 out of 5 stars 44 reviews

Age 42

 Thank you for your question. The simplest and easiest thing you could do to improve these areas would be Botox. The step above that would be fillers. You are also the right age where people start thinking about laser or chemical peels. Finally,  blepharoplasty would be a good and permanent option for this area.

P. Daniel Ward, MD
Salt Lake City Facial Plastic Surgeon
5.0 out of 5 stars 30 reviews

Facial Rejevenation: Information

Dear Ms. Crudelia74,

Thank you for your story, questions and photos.
Different terms mean different things to different people.
Each persons needs, wants and desires are a little different and thus only after a actual
consultative appointment and physical exam can one determine what individual procedures (or combinations) will be needed and best for you to reach your goals.

Based on just the photos you would optimally benefit from a combination of:
1) non invasive (lasers, Radio Frequency, skin care/aesthesticians and medications)
2) minimally invasive (fillers, collagen stimulatents, internal skin shrinkage (Themi Lift)
3) short hidden incisional skin contouring (face/neck lift, brow lift, blephroplasty, fat injections, etc).

I would contact a Plastic Surgeon in your area that not only performs surgery (if needed) but in addition has collection of up to date non surgical technology.

When we combine non surgical and short hidden incisional techniques together we refer to this concept as "Synergy".... each technique magnifying on each other to obtain results you could not achieve with just surgery or lasers alone.

Please make several consultative appointments with experienced Plastic Surgeons who are Certified by the American Board of Plastic Surgery and ideally a member of the American Society for Aesthetic Plastic Surgery (denoting by membership as having met additional criteria and a focus on Cosmetic Plastic Surgery).

My best wishes,

R. A. Hardesty, MD, FACS
Diplomate and Certified by the Am. Bd. of Plastic Surgery
4646 Brockton Ave
Riverside, Ca 92506
(951) 686-7600

Upper eyelid surgery with lower eyelid laser

Of course a full eye exam would be beneficial, but based on your pictures I feel that you would best benefit from an upper blepharoplasty along with a lower eyelid fractional CO2 laser treatment. The upper bleph would remove the extra saggy upper eyelid skin, and the laser (on the lower lid) would make the wrinkles (underneath and crow's feet) much improved. The procedure should take no longer than an hour and most likely can be performed in your PS's office under local anesthesia. Recovery time is a few days with makeup needed for the resultant temporary pinkness after the laser treatment (can start 6 days after day of procedure).

Paul Lanfranchi, DO, FAOCO
Las Vegas Facial Plastic Surgeon
4.9 out of 5 stars 49 reviews

Wrinkles eyes and eyebags. Will a blepharoplasty be a good solution?

 Hi, from the photo the upper eyelids do appear to have excess skin.  The lower eyelids seems to show excess skin but no fat pads.  Upper Blepharopasty can reduce the excess upper eyelid skin.  A skin pinch combined with a lower lid skin cghemical peel can reduce some of the excess wrinkled skin.  Any treatment more aggressive that that could result in the lower eyelid being pulled downward creating a rounding (malpositiuon) of the lower eyelid.

Hope this helps.

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.6 out of 5 stars 24 reviews


From this picture you should do well with 4 lid bleph.  It will NOT remove all of your wrinkles, but should help to rejuvenate this area.  For the lower lid:  you have some hollowing so may need either filler or fat injections as well.  Some laser resurfacing may also help with the skin texture 

John J. Martin, Jr., MD
Coral Gables Oculoplastic Surgeon
5.0 out of 5 stars 24 reviews

What to do?

Good question.  First of all, not bad!!     There are a lot of options out there.  Probably that is one reason you are asking your question.  In the facial area everything needs to match.  I would recommend seeing a surgeon or surgeons for a consultation to go over your surgical and nonsurgical options.  Your question is probably one of the most common questions asked.  Have fun exploring your options.

George Orloff, MD, FACS
Burbank Plastic Surgeon
4.1 out of 5 stars 11 reviews

Wrinkles eyes and eyebags

A good set of photos- is needed in order to comment accurately. Based on the photo you have submitted- you might benefit from an upper lid blepharoplasty to remove excess skin and Botox- for crow's feet areas, and possible peels and/or laser treatment to treat the under eye area. 

Cosmetic upper and lower eyelid surgery candidate

 A full set of photographs are required to make a determination about what may be needed. The primary goal for upper eyelid blepharoplasty is to remove excess skin creating the  hooded look. The primary goal of lower eyelid surgery is to remove the fatty deposits creating the puffy look. When there is extra skin at rest, (not upon animation) consideration for a pinch technique of excess skin can be performed. crows feet are best treated with Botox. For many examples of eyelid procedures, please see link and the video below

William Portuese, MD
Seattle Facial Plastic Surgeon
4.7 out of 5 stars 126 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.