Lower bleph question - what do you recommend? (Photo)

Hello and thank you for your question. A formal evaluation would be needed to determine the best treatment. There are both surgical and non-surgical options to correct this, depending on your specific situation.

For less significant puffiness and sagging UNDER the eyes, or more mild improvement, there are nonsurgical treatment options: we often use Renuvion helium plasma radiofrequency (RF) energy to achieve incredible results and take years off of your appearance. Combining RF energy and cool helium plasma, the signs of aging (wrinkles, pigmentation, skin laxity) are improved in a ‘Nonsurgical Lower Eyelid Lift.' The focused heating tightens and peels the outer skin layer with extreme precision, leaving the surrounding area undamaged, smoothing and tightening the periorbital skin, and improving the overall skin quality around the eyes. It's an aggressive treatment, and the recovery time is longer than with other nonsurgical procedures, but the results can be life-changing.​

Surgery (a lower blepharoplasty with or without canthopexy/canthoplasty or orbicularis muscle suspension) is a great option for more significant improvement- for example if there are more severe lower eyelid bags / bulging present. Sometimes the surgery can also be used to intentionally adjust the shape and/or size of your eyes, or correct any asymmetries!

Dr. Donald Groves is an expert facial plastic surgeon that I work with, who specializes in these types of procedures. It is important that if you are considering surgery that you go to someone who is well trained and very experienced with these delicate operations to get the best results. I suggest getting a consultation with an experienced cosmetic dermatologist and facial sculpting expert, or an aesthetic facial plastic surgeon like Dr. Groves; we are both located right here in Los Angeles.

Best,
Dr. Emer

Hello,
Thanks for your question. To improve your under eye wrinkles, I would recommend laser resurfacing of your lower eyelids, neurotoxin injections, and maintenance with anti-aging eye creams.
Living in Colorado can take a toll on the eyes because of the sun and low humidity.
I hope this helps.
Regards,
Dr. Shah

You will likely have the best outcome from a combination of treatments. Morpheus8 uses RF technology combined with microneedling to improve overall skin tone and texture. Three treatment sessions are recommended for optimal outcomes. Lasers are another option. We always recommend using medical grade skin care products and wearing sunscreen every day.

I don’t think a lower eyelid blepharoplasty will successfully treat your lower eyelid wrinkles.
Treating these is difficult and the best way is to avoid developing them by living a life of son of avoidance and meticulous use of sunscreen, starting at an early age.
When that’s not been the case treatments become more limited.
Botox can help and so can skin surfacing treatments, but in the end damage is difficult to reverse.
It’s a stubborn problem, and the curse of aging continues despite our best efforts.
It’s never too late to start wearing sunscreen.
If you haven’t done so already, then start a daily sunscreen regimen being cognizant of excessive sun exposure as well.
Keep expectations realistic when it comes to surgical correction for this.
It is an inherently difficult condition to treat.
The loss of skin elasticity that comes from age and some damage usually doesn’t get better.
Some providers may recommend retina and a variety of other treatments.
Like I mentioned earlier, some of these can be helpful, but they aren’t going to make the problem go away completely.
Likewise, the problem is likely to get worse with age and the best treatment is prevention.
Best,
Mats Hagstrom MD