Severe Under Eye Wrinkles After Blepharoplasty

Question

I had upper and lower blepharoplasty about 4 weeks ago. I am looking for the best possible follow-up treatment to remove or greatly diminish the under eye wrinkles and possibly make that area a bit more taut.   Thanks so much.

Frank P. Fechner, MD · Answer

I assume that you had a transconjunctival ("inside the eyelid") blepharoplasty with some additional wrinkling after the fat was removed. In this case, there are a few options to discuss with your facial surgeon:
1. chemical peel
2. laser resurfacing
3. skin pinch
If you had blepharoplasty with the incision right under the eyelashes, then I would adivce you to wait for further healing to take place before considering any additional treatments.

Richard D. Gentile, MD · Answer

We utilize a graduated system of addressing lax skin under the eyes. We usually perform some volume replacement with our lower lid surgery that addresses wrinkles by inflating the lower lid volume. We also perfom fractional ablative resurfacing, peels and skin pinch or excision. As you have addressed, this is severe, and we would look at some volumizing combined with skin excsion.

Brent Moelleken, MD · Answer

Since you are very soon after your surgery, it is best to wait until all the swelling has gone (typically 6 months).  You wouldn't want to reoperate on temporary swelling.  Peels and laser could typically be done much sooner than the six months.
There are several options if the looseness persists beyond that.
If your problem before your last surgery was lax skin, the problem will likely still be there after a transconjunctival blepharoplasty.  The transconjunctival blepharoplasty is designed to reduce fat, and does not typically affect the skin.
Peels and lasers can tighten the skin somewhat, and for a small amount of laxity that technique may be just the thing. 
If true loose skin is present, a skin pinch is an option but can deform the lower eyelid, creating a downward vector on the lower eyelid, that, if uncounteracted with a like pull upward (ie through a cheeklift) can cause lateral orbital pulling down of the eye or rounding of the lower eyelid.  This change in eyelid configuration often takes months to develop as the forces of healing pull down on the lid.
For that reason, we typically perform a USIC, ultrashort incision cheeklift to prevent this from happening in all cases when we perform a skin pinch.

Kenneth D. Steinsapir, MD · Answer

Dear Jen Jen,
At 4 weeks out from eyelid surgery, you are very early from the eyelid surgery. If you are interested in further improving the eyelid skin wrinkling, you should discuss this with your current surgeon. Any plan to rejuvenate the lower eyelids should address the wrinkles of the lower eyelid. This may involve removal of skin during the eyelid surgery or by skin resurfacing which can be done in a variety of ways. These treatments can be performed at the time of surgery or can be separated in time from the surgical procedures depending on patient and surgeon preference.
I think it is only appropriate that you discuss your concerns with your surgeon in whom you trusted your eyelid surgery to. This person should be highly motivated to help you achieve you goals. If for some reason you have decided to not work with this individual, I think most surgeons will want to wait until you have fully recovered from your eyelid surgery before further addressing any residual issues.

Robert W. Sheffield, MD · Answer

Thank you for voicing out your concern. You have mentioned that it has only been 4 weeks since your blepharoplasty surgery and you noticed these wrinkles, which bothered you. Primarily, I would suggest that you discuss this with your board certified plastic surgeon so he or she could evaluate the situation through proper assessment. After that, I would like to assure you that you are still in the healing phase of your surgery. Usually, I advise my patients to wait for at least 3 months for complete healing to take its course.  I understand that you might find this traumatic, but please rest assured that this wrinkling will heal up in time. After a surgery, the skin surrounding the area tends to become a bit loose. However, as time will pass, the skin will shrink back to its initial firmness and state. That said, if after a few months post the healing phase the skin is still wrinkly, your options to fix it back would include chemical peels, lasers, as well as re-operation. You can discuss this directly with your board certified plastic surgeon. Do not hesitate to ask questions if you need to know more. Best of luck!

Severe Under Eye Wrinkles After Blepharoplasty

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Severe Under Eye Wrinkles After Blepharoplasty

Answers (10)

Answer: It is best that you discuss this with your surgeon

Answer: It is best that you discuss this with your surgeon

Answer: Extensive Wrinkles Under the Eyes Post Blepharoplasty

Answer: Extensive Wrinkles Under the Eyes Post Blepharoplasty

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Everything you need to know about Eyelid Surgery

Our mission is to create a world where every investment in modern beauty is Worth It.