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Upper bleph in 2022. What else can be done to treat fine lines and wrinkles under my eyes & crows feet when I smile? (Phtos)

Katie8464Oct 21, 2025
I had a Lowe bleph, canthal tightening, fat transfer and laser of the lower lids in 2022. I have a lot of fine lines and wrinkles under my eyes and crows feet when I smile. What else can be done to correct this? Upper bleph? Skin pinch? I do have botox

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C. Blake Perry, MD profile photo
Dr. C. Blake Perry, MD
Oculoplastic Surgeon, Board Certified in Ophthalmology
5.0 | 16 Reviews
Answered on Oct 29, 2025
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C. Blake Perry, MD

Options to improve the area: Additional fat grafting to help restore volume; strategic neuro-toxin placement to help reduce wrinkles; laser resurfacing to help tighten the under eye skin. A skin pinch is not out of the question. Best to see an eyelid expert for an in person consultation.

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C. Blake Perry, MD

It appears the right upper lid nasal fat pad was not appropriately reduced. This is a relatively straight forward procedure to fix. A lid crease incision is again used (ie the same incision site used for your upper lid blepharoplasty) and the fat is appropriately excised or transposed. Best to...

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C. Blake Perry, MD

Part of the asymmetry is secondary to the asymmetric upper lid creases. Surgery on the left upper lid to create an eyelid crease and fix any ptosis would help improve your symmetry. This is a particularly challenging surgery. Best to see an eyelid expert.

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