Looking for best alternative to lower eyelid surgery in my case. What would be the best? (Photo)

Thank you for your question.While a surgical lower lid blepharoplasty would be the most effective procedure to help remove some of the excess skin of your lower lids there are several non-surgical alternatives that in combination may give you a satisfactory cosmetic result with virtually no downtime.  This may include botox for the crows feet, restylane for the hollowness of your tear trough, and potentially ultherapy for the periorbital region.I would recommend following up with a board certified plastic surgeon to discuss the various non-surgical alternatives to help address your lower lids.

Both can be used for lower eyelid wrinkles, but you will not achieve the same thing (or for the same length of time), so Be sure to discuss your goals and concerns with your board certified plastic surgeon and consider the pros and the cons. Be certain your surgeon is properly certified.  I've attached a link where you can start your search. 

Hello and thank you for your question. Based on your
photograph, I would agree with the surgeons you have seen that the best way to achieve your goals is with lower eyelid blepharoplasty. 
Fillers are another option which could have some improvement.
Best wishes and good luck.
Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Thanks so much for reaching out. Definitely lower eyelid surgery will do the most to improve your lower eyelids. However if this is not appeal to you you can start off by adding filler to the tear trough in a dry area to add volume. Followed by full facial resurfacing good either laser or a chemical peel.   Sure you see a board-certified plastic surgeon especially for the under eye injections. As this is an advanced filling technique. 

The primary goal of lower eyelid surgery to remove the fatty deposits creating a puffy look in the lower lids.n The secondary goal is to conservatively tighten loose and inelastic skin in the lower lids. Botox is used to treat crows feet. Any type of laser treatment will take a few weeks to heal from

Alternatives to surgery for addressing wrinkles in the lower lids involve skin tightening techniques such as laser resurfacing or chemical peels. Some recovery time is required as the skin will be red for at least several days. Another option to consider is a series of radio frequency treatments with the  Venus Legacy or similar device. Results will be subtle but no downtime is needed. Fillers for hollowing and Botox for lines of expression are also considerations.
Best, 
Scott A. Brenman, M.D., F.A.C.S.
Plastic & Reconstructive Surgery

Thanks for your questions. Based on your photo, I understand why other surgeons have suggested surgery. That being said, if you are not interested in that option, there are still a few different approaches. You could try filler like Restylane to the tear trough in combination with Botox. This will likely lead to improvement, but will not totally eliminate the wrinkles. Good luck!

There are things only surgery will do, but lucky for you there are other modalities that can improve the lower lids without surgery.  In my practice, we offer a total lower lid rejuvenation package that includes Clearlift Laser, Pelleve and Restylane under eye filler.  This combination works to tighten the skin, improve texture and crepeyness and fill in hollowness.  Look for a plastic surgeon who offers a variety of modalities to treat skin texture and tighten the skin.  There are many available options for folks like yourself who are not interested in surgery.  

Botox can be used to reduce the crows feet and the wrinkles that exist on the outer one third of the eyelid.  However Botox cannot be used on  the two thirds of the eyelid near the nose as this would paralyze the lid and cause eye problems.  Even a blepharoplasty will not remove eyelid wrinkles and because of the structure of your ete, cheek and lower eyelid he would be at risk for ectropion or sagging of the lower lid, and I would not do a blepharoplasty on you. Were you to eventually want to tighten the eyelid is surgical procedure called a canthopexy or canthoplasty should be considered.