Lower eyelid surgery for syringomas and veins? (Photo)

Thanks for your picture.  I agree with Dr. Martin, selective discrete removal is the best treatment followed by some resurfacing procedure (peels, Laser)

#Eyelid syringoma and vein treatmentthese are best done with lasers ,   surgery will not improve these problems

Syringomas are benign growths of the sweat glands.  Not sure how you did the treatments with the CO2 laser, but that is the best treatment available.  But not resurfacing.  You need to use a handpiece that just cores out the gland.  May need at least 2 treatments to get them all.  YOu get a scab for a few days but otherwise heals well.  Once they are all gone you might want to resurface if the skin is a little irregular. Just zapping the top with erbium is NOT going to work, and nor will peels.   

Syringomas can be difficult to treat.  Given the significant amount that you have, it would be best to try to isolate and treat them with the laser.  I would recommend doing a test area on 2 or 3 to see how the results are prior to jumping in and trying to treat them all.  The last thing you want is a result that is less favorable than your current concerns.

. At age 44, And looking at your photos,It doesn't appear that you have a lot of loose skin.So you might be better off with pinpoint CO2 laser treatment Using a very small focused beam to "zap" each individual syringoma. This may require more than one treatment.

These little buggers are tough to treat. They are benign sweat gland growths and tend to have high rate of recurrence. I have found that burning these individually with a hyfrecator (which is an energy pencil) can help to obliterate them. There have also been reports of success using continuous wave co2 laser 

As you are probably aware, syringomas are specialized sweat glands which can become cystic and most often involve the lower lid.  This is largely because the lower lid skin is extremely thin and glands in the skin are extraordinarily visible.  The best treatment is laser ablation which I have found works best with an ablative  (non-fractional) CO2 laser.  These have to be treated aggressively by individually vaporizing them down to the muscle.  Amazingly there is little scarring and the added benefit of some skin tightening with this process of evaporation.  Of course special precautions should be taken to protect the eyes.  The recurrence rate is extremely high and I have suggested the use of tretinoin and ultrasonic brush scrubbing to help inhibit the return of these.