My lower eyelids wrinkle a lot when I smile, lower blepharoplasty candidate? (Photos)

Question

My lower eyelids wrinkle a lot when I smile, causing excess skin to bunch and create deep grooves. I can pinch the skin with my fingers. Am I a good candidate for lower blepharoplasty?

Gary M. Horndeski, MD · Answer

You are an excellent candidate for Botox.  You are not a very good candidate at this time for a lower blepharoplasty.

Best Wishes,

Gary Horndeski, M.D.

Chet Mays, MD · Answer

Thank you for your inquiry! Looking at your photos, you would be a great candidate for a lower bleph procedure as that takes away excess skin / fullness. We would love to sit down with you and explore options to help you reach your goals. I recommend scheduling a consultation with a Board Certified Plastic Surgeon like myself so we can create a surgical plan.

Nelson Lee Novick, MD · Answer

Before jumping into aggressive, expensive blepharoplasty surgeries that entail the risk for prolonged downtimes, infection and even scarring, you may wish to consider an entirely nonsurgical approach. Botox can be used to treat the crow's feet that worsen with smiling (I.e. dynamic wrinkles). At the same time a low viscosity, malleable, cohesive HA filler can be fanned through this same area to address to further provide the "infrastructure" to resist the wrinkling with motion and to improve the appearance at rest. These approaches engender little to no significant post-treatment downtime. You would be wise to consult with a board certified cosmetic dermatologist injector expert. The simplest solutions are often the best solutions. Best of luck.

Zoran Potparic, MD · Answer

Based on these photos it appears that you are a candidate for lower blepharoplasty, possibly conservative periorbital fat grafting? Skin only lower blepharoplasty technique would be my suggestion. Good luck.

Pawel Szychta, MD, PhD, DSc · Answer

Based on your description, it sounds like you could potentially be a good candidate for a lower blepharoplasty. Since you’re already noticing these concerns at a younger age, this could suggest that genetics or early aging is at play, and lower blepharoplasty could potentially give you long-lasting results.Consult a board-certified oculoplastic surgeon or facial plastic surgeon to discuss your concerns and whether you’re an ideal candidate for lower blepharoplasty.

William Portuese, MD · Answer

The primary goal for lower eyelid surgery is to remove the fat bags creating the puffy look on both lower lids. The fat is removed through a trans conjunctival approach on the inside of the lower lids. If there's excess skin at rest(not when smiling), then you can consider a pinch of skin. Those are usually performed on patients over 50 years of age. In our practice, we close that incision with tissue glue, and no sutures are required. Botox is best for your crows feet.

Robert L. Kraft, MD, FACS · Answer

Thanks for reaching out. Yes, you are a candidate for lower lid blepharoplasty. Everyone gets “the crinkles” when they smile but the hollows under your eyes and the excess skin would be improved. See a board certified plastic surgeon in consultation. This is a procedure that is performed in an accredited office-based facility with sedation anesthesia. Best wishes.

Darryl J. Blinski, MD · Answer

Based on your series of nicely posted photos, I would recommend a combination of treatments and surgeries. Micro Botox for crows feet, lower lid, pinch lift, and Endo lift laser treatment to lower lids. Fee $10,000-$15,000. Virtual consult with.

Mats Hagstrom, MD (license on probation) · Answer

I’m not a fan of removing skin from the lower eyelid to try to treat sun damage related wrinkles.
There is in fact, no good treatment for treating these wrinkles.
People will probably recommend laser resurfacing or chemical peels, which may help temporarily to some degree.
 Long-term they don’t seem to do all that much from what I’ve seen.
Botox can help and volume enhancement with fillers can also be very helpful.
Provider selection is variable.
The area is pretty complex and not always easy to treat.
Expect different providers to have different opinions.
That is often the case the problem is complex and there is no single one best treatment.
Prevention is the best way of not getting wrinkles in the lower eyelid.
Daily sunscreen and avoiding excessive sun exposure is by far the best way to prevent this problem.
Some people find retin-A to be helpful for reversing sun damage on skin
Good luck,
Mats Hagstrom MD

My lower eyelids wrinkle a lot when I smile, lower blepharoplasty candidate? (Photos)

Answers (9)

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