Skin Wrinkling After Lower Blepharoplasty

Postoperative swelling is of course the rule after blepharoplasty. There is a phase when the eyes can appear "crepey". Waiting until swelling subsides, typically six months, is the standard answer.
The nature of the problem may depend on what was there before the surgery. If there was loose skin present below the eye and nothing was done about it, the loose skin will still be there. If a transconjunctival blepharoplasty was done, with strict fat removal, this can cause the appearance of crepiness to increase.
How to remove the extra skin below the eyes is a very difficult problem. I would respectfully disagree that removal of a pinch of skin is even an option. Removal of lower eyelid skin in my opinion, even if it is "just a pinch" performed with a transconjunctival blepharoplasty, has a high chance of changing eye shape. This change in eye shape typically takes two forms: pulling down of the corner of the eyes, and rounding of the eyes as the lower eyelid skin retracts postoperatively. The retraction is typically not apparent for several months postoperatively.
When a simple canthopexy in combination with a pinch of lower eyelid skin removal is performed to prevent this, another typical deformity can result: rounding of the eyes with a severe upturn at the corners where the canthopexy was performed.
In our practice, we perform midface elevation procedure to tackle the problem of loose skin of the lower eyelid. A superficial cheeklift (the latest version of this technique is called the LUSIC, or LiveFill graft ultrashort incision cheeklift. Here, the cheek is elevated slightly through an incision at the corner of the eye. Sutures are used to anchor the cheekpad higher, "giving" tissue to the lower eyes. Then, a small amount of skin can be removed without significant chance of eyelid shape aleteration.
If the lower eyes have already been done and the eye shape exhibits the typical post-blepharoplasty changes described above, a cheeklift is also helpful in reducing those. LiveFill grafts are used judiciously to restore volume at the same time.
These are all quite complex issues, but patients should be very aware of how their eye shape can be permanently altered with many lower eyelid procedures. The lower eyelid skin, the canthus, the lower eyelid itself, eye shape as a whole, the relationship between the upper and the lower eyelids are all important to consider preoperatively.

It is not possible to make an accurate judgement of the lower eyelids at this point. If you have extra skin wrinkling, it just means your surgeon was cautious by under correcting the lids. At 6 months, there are a few options to tighten the skin. At that time see your surgeon for evaluation and treatment tailored to the severity of the wrinkling. Good luck.

Fine wrinkles of the lower eyelids
are not uncommon following blepharoplasty surgery.  In the first two weeks after surgery this type of wrinkle
should not be the source of anxiety.

Wound healing is a dynamic process
that’s characterized by rapid change in the early post-operative period.  At this point in time, the lower
eyelids often have bruising, swelling and wrinkling.  These phenomena gradually resolve over the course of several
weeks as the process of wound remodeling begins. During this process, wrinkles
gradually smooth and flatten as a result of skin elasticity.

                  It’s
important to be patient since the body has a tremendous potential for tissue
remodeling. In some cases, massage of the lower eyelids can facilitate smoothing
of the lower eyelids. Occasionally, wrinkles persist and secondary procedures
should be considered. Under these circumstances, laser resurfacing is effective
in treating fine wrinkles of the lower eyelids.

It is still early in the recovery period and would ask that you allow everything to heal. Lower blepharoplasty is a good procedure to rejuvenate the lower eyelids, by removing the lower eyelid fat and some of the wrinkles. However, it will not remove all of the wrinkles.

It is impossible to make judgments about the aesthetic outcome of your operation 2 weeks after the procedure.  You should wait until you are fully healed and then asses the results.  If wrinkling is persistent, there are various treatments that might help.  Now is not the time to employ them.

You should definitely wait longer before making any judgements about your surgical result. It may take up to several months for your skin to fully heal from the blepharoplasty. In the meantime, leave it alone other than your normal skin care routine. If there is persistence of the fine lines after adequate time to heal, you may be a candidate to have a chemical or laser peel to further augment your results.

Matreshka,
2.5 weeks is fairly early to start getting worried about your eyelids after blepharoplasty. Often it takes several weeks to months for the tissues to settle and the swelling to resolve. At the same time, the tissue is healing and the collagen is reorganizing. All of this leads to changes after surgery which may not be apparent yet. However, if after several months you do not see a significant change and still see extra skin, you can have a straight-forward revision or secondary surgery which will help tighten up the extra skin. However, do not be tempted to rush into any revision surgery before your first surgery has completely healed.
David Shafer, MD

Wrinkles under the eyelid are not necessarily treated by a lower eyelid blepharoplasty. The fine lines and wrinkles are often treated with a skin resurfacing procedure such as a chemical peel or a CO2 laser peel (regular or fractional).  The lower eyelid blepharoplasty is aimed to treat bags under the eyed that result from fat pads that protrude with age.  These should be better after blepharoplasty surgery.

Unfortunately, lower lid blepharoplasty is not a great procedure for wrinkling under the eyes. It is good for removing bulging, fat-causing bags. Wrinkles under the eyes can be difficult to treat. Treatment may involve skin removal, fillers, or resurfacing procedures.  While each case is different, the first important step is determining the cause of the wrinkles under your eyes, but again, this can be a tough problem.

2 weeks post-blepharoplasty is too early to evaluate the excess skin. There is often alot of swelling after a blepharoplasty, and you have to give the skin some time to go back to normal.