4 years post blepharoplasty and my skin is very lax and crepey, can this be fixed? (Photo)

Question

I had an upper blepharoplasty years ago and since then my eyes have looked very crepey and lax on the platform lid , my skin looks very wrinkly I’m only 31 and heartbroken about this. I can close my eyes but they feel tight but not skin wise it’s like the underlying structure is tight, I went to have a consultation And the dr told me my crease has been attached to the levator across the entire lid and told me I have no options to fix it. I believe someone can help and I’m not expecting my kids to look like they did prior but I’m sure some type of revision can fix.

Mehmet Ozdemir, MD · Answer

I understand how distressing it is to feel that your concerns are being dismissed, especially when you are dealing with both a physical sensation of tightness and a "crepey" texture that doesn't align with your age. From a clinical perspective, the issues you are describing the skin laxity on the platform and the internal tugging often suggest that the skin-muscle-levator complex was fixated too high or too firmly during your initial blepharoplasty, leading to what we call "tethering." While your previous consultant was hesitant, complex revision cases often require an oculoplastic specialist (a plastic surgeon specifically trained in eye structures) who can perform a surgical release of those adhesions. This may involve internal scarring release and the placement of a small fat graft or a "spacer" to prevent the tissue from re-adhering, which can restore a more natural glide to the eyelid and smooth out the surface. I strongly encourage you to seek a secondary evaluation with a high-volume revision oculoplastic surgeon; there are advanced techniques available today that can improve both the structural mobility of your lids and the aesthetic quality of the skin.

Kyle Kimura, MD · Answer

Thank you for your question and photos. 
I think you likely have a couple of options based on how bothersome your issues are. The more conservative option would be to consider a laser resurfacing procedure (CO2 or Er:YAG) to help address some of the crepiness of the skin. The second option, and I think would need a full exam to determine if you are a good candidate, would be a revision upper blepharoplasty and release of any of that tethering scar plus potentially excision of further skin (if needed). I think your best next step is to schedule another consultation with a plastic surgeon or oculoplastic surgeon that specializes in eyelid surgery to discuss your options, as I feel like either of the two options I mentioned should be possible for you. 
Hope this helps and best of luck! Kyle Kimura, MD

Zoran Potparic, MD · Answer

It appears that you may have unilateral eyelid ptosis? This needs to be properly evaluated and addressed if confirmed. A thin layer of nano fat grafts over tarsal plate and proximal to it would improve wrinkling and laxity? Good luck.

Gautham Ullas, BMBS, BMedSci, FRCS (ORL-HNS) · Answer

There are levator release techniques. Unfortunately they usually cause the lid position to change. I recommend seeing an occuloplastic surgeon like Mr Naresh Joshi in London.

4 years post blepharoplasty and my skin is very lax and crepey, can this be fixed? (Photo)

Answers (4)

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