I have so many folds above and below my eyes, I'm only 19, what can be done to help this? (photos)

Question

My eyelids have so many folds and are so crepey looking. Also, what is up with the two huge lines under each of my eyes? Like the part where it is really sunken in under my eyes. I'm 19 and feel like I look way older in my eye area than I am. It makes doing makeup so much harder for me and wonder what can be done to help it, please please please

Nelson Lee Novick, MD · Answer

While it is necessary to have a bit of extra skin above the eyelids in order to be able to close your eyes properly, it does appear from the photo that there is a bit more than the usual crepeyness and crinkleyness in that region. Likewise, the under eye region does show a fairly pronounced tear trough and some darkening. To rule out that the crepeyness of the upper eyelid is not related to excess dryness, allergy, or irritation, I would suggest the use of a mild anti-inflammatory cream applied twice daily for two to three days. If  there is no change, the aforementioned problems are unlikely, and the crepeyness may be more directly addressed by the appropriate injection of a filler. A small amount of a filler layered along the border of the eyelid and the brow skin  should help to smooth this area. Likewise, filler appropriately placed in the region of the tear trough should help to smooth this region and create a smoother, more gradual transition between the cheek and the under eye area and may even lighten some of the darkness there. Belotero Balance is my preference for the periorbital  area in my Upper East Side Manhattan office since it possesses little to no tendency to give rise to the unwanted, bluish Tyndall Effect when injected superficially into the delicate skin around the eyes. (In my Israel satellite facility, where a far greater number of regulatory agency approved fillers are available, I would opt for Teosyal Redensity II). Injecting the periorbital region is an advanced injection technique that should not be left to inexperienced injectors accustomed to injecting simple Restylane or Juvederm into ordinary smile lines. Be certain to seek consultation and treatment by a board certified aesthetic physician and make sure to ask to see his/her before and after photos before agreeing to proceed. Best of luck.

Brett S. Kotlus, MD, MS, FACS · Answer

Your upper eyelids are meant to have a bit of extra skin when your eyes are open so you are able to close them.  That being said, there are several approaches to making this area smoother, including a well-planned skincare regimen that includes treatment to your eyelid skin, a conservative laser resurfacing of the upper eyelid skin and filler treatments to help round-out and smooth the area under your eyebrows. At your age, don't do anything drastic- less is more.

Soheila Rostami, MD, FAAO, FAACS · Answer

you are young and beautiful. There is nothing wrong with your eyelids. the only thing I would say, you have just slightly more prominent tear trough. and that can be helped with a little filler under the eyes. your upper eyelids are beautiful.

Joel E. Kopelman, MD, FACS · Answer

Hello and thank you for your question. The texture of the crepey skin could be due to dry skin or other such skin issues that can be helped by following a strict face care regime and use of the right creams such as an anti-inflammatory one. If this does not help, however, I would recommend a non-surgical procedure such as filler treatment. I generally use Belotero Balance, an FDA approved dermal filler, is a soft cohesive “sugar” gel made of hyaluronic acid naturally found in our bodies in skin and soft connective tissue and is ideal for injections around the eyelids.
Another option would be laser treatment. Laser energy can be precisely adjusted to gauge the depth of treatment. This controlled removal of skin allows the body to naturally regenerate a smoother new layer of skin that is noticeably less wrinkled. This process is commonly referred to as laser resurfacing.

Lesley A. Rabach, MD · Answer

Thank you for your question and your photos. The upper eyelid is meant to have some extra skin so that it closes well. That being said, if your skin has a crepey texture it could be related to how dry your skin is. For the undereye area if you want to reduce the slight hollow, I would recommend a small amount of filler  (restylane) to reduce the shadow. I hope this helps and good luck!

Brian A. Pinsky, MD, FACS · Answer

hello. Thanks for your question. You have a combination of a high-riding tarsal crease of the upper eyelids and flatter cheeks bones. All are totally normal but result the appearance that you are noticing. If anything, you should consider trying filler injections to the lower eyelid tear troughs and even upper eyelids. If you like the results, you can then consider fat grafting for a permanent fix. I would recommend a consult with a board certified plastic surgeon. Good luck!

Javier Galindo, MD · Answer

I will recommend that you have fat transfer to your upper eyelids and CO2 resurfacing to the skin of both upper and lower. That will enhance your beauty without a very invasive operation since you are very young

Sara A. Kaltreider, MD (retired) · Answer

Crepey skin in young people is generally a result of mechanical manipulation of the lids - for ladies - that's usually one of two circumstances - either rubbing because of allergies, or applying and removing makeup. Eventually, the skin stretches, becomes inflamed, darkens, and acquires fine wrinkles. If you have allergies, then treatment might help the appearance. Regarding makeup - gentle makeup remover and small dabbing movements rather than long sweeping/ pulling movements will minimize the trauma. Micropigmentation of permanent or semi-permanent eyeliner is a nice option that eliminates the need to apply and remove the liner every day. The crepe-like quality of the skin can improve to some extent if the rubbing is minimized or eliminated. CO2 laser resurfacing is an option, but would provide only transient benefit unless mechanical factors are addressed. Best wishes.

I have so many folds above and below my eyes, I'm only 19, what can be done to help this? (photos)

Answers (8)

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