Weight loss caused wrinkles and sagging in the eye area - how should I treat this? (Photos)

Question

I lost a fair bit of weight and my eyes now have so many deeeep wrinkles. I do also have sagging in other parts of my face but the eyes are what really bother me. I’ve previously had a facelift but then lost a lot of weight and destroyed it. I don’t have the time, money or inclination for another facelift but I’m open to almost anything else that will actually help.

Anna Petropoulos, MD, FRCS · Answer

Hello Creative929132,
  Congratulations on your weight loss! While it's a wonderful accomplishment, it's very common to notice a loss of facial volume afterward. As we age, we naturally lose collagen and fat in the face, and weight loss can make these changes more noticeable, especially around the cheeks and eyes.
  Based on your concerns, I would likely recommend a combination approach rather than relying on a single treatment. Starting with a neurotoxin such as Botox can help relax the muscles around the eyes and soften the appearance of crow's feet and dynamic wrinkles.
 About two weeks later, I would consider a series of radiofrequency microneedling treatments, such as Morpheus8 or Sylfirm X. These treatments create brand new baby skin cells in the treated area. They stimulate collagen production and help improve skin laxity and texture over time. Most patients benefit from a series of three treatments, with results continuing to improve over the following several months.
  If volume loss is contributing to your concerns, a hyaluronic acid filler such as Voluma may also be an excellent option. Placing filler along the cheekbones can restore lost volume, provide support to the midface, and create a more refreshed, natural appearance.
 The best treatment plan depends on your anatomy, skin quality, and aesthetic goals, so I recommend an in-person consultation with a board-certified aesthetic provider. They can determine which combination of treatments will give you the safest and most natural-looking results.

Best of luck on your continued journey! My name is Jeanine Oteri and I am a medical esthetician/laser technician with 25 years experience answering on behalf of Dr. Anna Petropoulos, MD, F.R.C.S.

Nelson Lee Novick, MD · Answer

At least from the tow photos provided, there clearly is pronounced crow's feet wrinkling with smiling and volume deficit and flattening of the upper cheeks at rest. 
So, both issues are a relatively easy fix. The use of a robust HA volumizing filler can reestablish the necessary volume to the upper cheeks, which would in turn create a more ideal feminine Ogee Curve and outward projection of the upper cheeks at rest. The additional volume would also diminish somewhat the pronounced crow's feet seen with smiling.   And, the use of Botox would substantially reduce the crow's feet seen with smiling. Both injection procedures can be performed in the space of about twenty minutes total in one treatment session (if so desired) in the hands of an experienced, expert board certified dermatologist injection expert and with little to no significant post-treatment downtime. No need for surgery.. It's bread and butter nonsurgical cosmetic dermatology.  Hope this 
helps and best of luck. .

Weight loss caused wrinkles and sagging in the eye area - how should I treat this? (Photos)

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