Crepey eyelid and crows feet skin - what are my treatment options? (photos)

Question

33 years old with w crepey eyelid and sagging . also i have hollow under eyes plus crepey wrinkly skin under eyes after getting botched tear trough filler dissolved x 5 this year and yet there seems to still be fluid bags under my eye when i smile (it’s so obvious when i smile)… please help me with this issue it’s killing my confidence . i’ll do anything surgery or lazer to fix the issue.

Raffy Karamanoukian, MD, FACS · Answer

Fractional CO2 laser is an excellent tool for skin rejuvenation in our center in Santa Monica. We use the fractional multi-depth ablative approach to help resurface the skin, recontour acne scars, improve incisional plastic surgery scars, and reduce surface irregularities from skin tone to dark pigmentation. Our approach utilizes a multi-depth approach that targets melanocytes in the epidermis and collagen fibroblasts in the dermis. This approach can be combined with a TCA Peel in a process known as a sapphire peel. Fractional laser is excellent for acne scars and contour scars in the skin. Patients are advised to undergo skin protocols with Melarase creams before and after treatment to help reduce pigmentation. Melarase AM, Melarase PM, and Melapads can seriously improve surface sun damage and UV related pigmentation. After the laser, we expect redness for a few weeks as the skin improves. PRP and Hydrafacial enzyme facials can further improve skin quality after fractional co2.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best,
Dr. Karamanoukian 
Realself100 Surgeon

Jason Emer, MD · Answer

As we age, our eyelids naturally sag and droop. A combination approach would be best to see visible improvement. In terms of non-surgical treatment options, I would recommend a Chemical Brow Lift (using Botox, Dysport, Xeomin, or Jeuveau) and filler injections to rejuvenate the temples, eyebrow, eyelid, eye troughs, upper eye hollows, and forehead. I typically combine this with Ultherapy and thread lifting to lift the brow; RF and skin tightening laser treatments to stimulate collagen production and rejuvenate the skin; and laser or superficial RF devices for improvements in texture, color, and any crepey skin around the eyes as needed. In some cases, surgery is the best solution to achieve the desired results. See an expert for a formal consultation. Best, Dr. Emer.​

Jonathan Kulbersh, MD · Answer

Thank you for your question and for providing photos. You may be a candidate for a blepharoplasty procedure, also known as an eyelid lift. This surgical procedure can address both the upper and lower eyelid concerns to improve their appearance. The area around the eyes can be revitalized by removing any excess skin, repositioning or removing facial fat, and tightening the muscles below the skin. This procedure may reduce the appearance of the sagging skin and wrinkles you describe. I recommend scheduling an in-person consultation with an experienced, board-certified facial plastic surgeon who can assess your needs on a more individual basis.

Theresa M. Jarmuz, MD · Answer

Starting with topical treatments that include retinol, retin A and peptides would help. DEJ Eye serum is formulated for upper and lower lids. A more aggressive approach would be CO2 Fractionated Laser. It would make a significant difference for you. You will need to find what down-time you are willing to accept and delineate your budget, as you can see there are treatment options on both ends of the spectrum. 
J Scaljon.

Yao Wang, MD · Answer

The redundant upper eyelid skin can be removed with surgery (upper eyelid blepharoplasty). Based on these photos, your lower eyelid does not appear to have excess skin but you do have some mild wrinkles. Laser or some kind of energy based device can help smoothen your lower eyelid wrinkles. In terms of the filler, if you still notice puffiness that comes and goes you may still have residual filler. I recommend going in to see an oculoplastic surgeon to see if you still may have filler present. Hope this helps!

Camille Cash, MD · Answer

From your photos it appears you may be a candidate for an upper blepharoplasty to remove excess skin from the upper eyelid.  For the lower lids you may consider Morpheus8.  These treatments use a combination of RF technology and microneedling to improve overall skin tone and texture.  See a board certified plastic surgeon near you for an evaluation.

Crepey eyelid and crows feet skin - what are my treatment options? (photos)

Answers (6)

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