I Am 57 Years Old and Have Excess, Loose Skin Under my Eyes?

My doctor wants to make the incision underneath my eyes in the lash line. Will the scar show and is this standard procedure? He also said filler may be an option intend of the incision.

Doctor Answers 11

Lower eyelid blepharoplasty, fat transfer or injectable filler

A lower eyelid blepharoplasty can be performed by making the incision through the skin or inside the eyelid through the layer called the conjunctiva. Once the incision is created a variety of procedures can be performed including fat removal or repositioning, lifting of the cheek and/or excision of skin. In general, the skill of the surgeon is more important than the technique employed as very good or not so good results can be obtained with any approach. In general though, the trans-cutaneous or through the skin approach does have a higher risk of pulling the lower eyelid down and so if this approach is used very conservative skin excision is advised. If filler alone would accomplish the task then that may be advisable. In our opinion, many lower eyelids do not need fat removed, but rather only volume added. This can be accomplished with filler or the patient's own fat cells.

Austin Facial Plastic Surgeon
4.9 out of 5 stars 45 reviews

I Am 57 Years Old and Have Excess, Loose Skin Under my Eyes?

Filler can be a temporary maneuver for a person who does not wish to make a surgical decision. However paint is not brick., A volume enhancement from an injection is never a three dimensional blepharoplasty result. Injections of Radiesse, and hyaluronic acid fillers have their place. Blepharoplasty tightens the muscle, often reduces or redistributes your fat volume, and takes away loose saggy skin. A lower blepharoplasty has an indication of both through the eyelid and under the eyelash line depending on the amount of excess skin you have. Some patients have fat injections, incision through the eye lining with or without laser resurfacing. Depending on your circumstances and your excess skin, your board certified plastic surgeon will discuss what you require to help you make the best choice for you. There is no such thing as standard procedure when it comes to eyelids. I would carefully review their pre and postoperative photos and discuss your expectations. I can assure you that an incision properly placed under the lash line is imperceptible with and coverable with makeup. But, you and your surgeon will always be able to see it.

Paul Vanek, MD
Cleveland Plastic Surgeon
4.8 out of 5 stars 30 reviews

Lower blepharoplasty incision

 In our practice, we remove fat through the trans- conjunctival approach, and when needed excess skin is removed through a subciliary incision. The subciliary incision heals quite nicely when it properly performed, since it's directly underneath the lash line.

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 145 reviews

Loose and excess skin of eyelids requires skin removal and tightening

Yes, removal of excess skin through incision made close to lash line in lower eyelids and in skin crease of upper eyelids and removal of excess fat pocket with skin tightening is standard procedure to correct your problem.

Fillers add to results but do not substitute for surgery.

Vasdev Rai, MD
Dallas Plastic Surgeon
5.0 out of 5 stars 23 reviews

I Am 57 Years Old and Have Excess, Loose Skin Under my Eyes

Hi Mrs Kitty

Both options suggested by your Doctor are good.The incision under the lash line is standard procedure and the scar will show for the first 6 weeks then it will fade. However after 2 weeks you can use some mineral makeup to conceal the scar. I use this incision most of the time.

Fillers will replace the volume that you have lost around your eyes. In the process of 'filling' the areas some of the loose skin gets stretched and it improves the look. The best analogy is to think of inflating a partially deflated balloon.

All the best

Naveen Somia, MBBS, PhD, FRACS
Sydney Plastic Surgeon
5.0 out of 5 stars 74 reviews

Subcillary lower eyelid incision

Aging of the lower eyelids usually involves both loose skin, herniated fat , descent of the malar cheek pad and sagging of the orbicularis muscle.  A subcillary incision, made just 2 mm below the lash line, is fairly standard when making these surgical corrections the incision will heal up nicely in most situations.  

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 19 reviews

Bags under the eyes

Generally speaking, I recommend to my patients coming in for extra eyelid skin in San Antonio to undergo an incision under the lash line.  If there is not a lot of extra skin, and all I have to remove is fat, then I will perform an eyelift through an incision inside the eyelid.

Suresh Koneru, MD
San Antonio Plastic Surgeon
4.5 out of 5 stars 19 reviews

Loose skin around eye

An incision along the lower lid is very common with a blepharoplasty for loose skin.  The incision is permanent but usually fades in very nicely and barely perceptible once it has healed.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

Treating loose skin under the eyes

Dear Mrs Kitty,

It depends on what your eyes look like

I, personally, do not like making an incision under the eyelashes because you violate the muscle that surrounds the eyes in that approach if you are also taking fat out

Also, you have to be careful that the weight of the cheek doesn't pull the skin down and cause rounding of the corners of the eyes

Instead, I remove fat through an incision within the eye and do a fat transfer to the the area around the eye and cheekbone for a nice blended look

If you are not comfortable with the plan, I would suggest seeing 2-3 surgeons and you can pick the one you like best

Best regards,

Nima Shemirani

Nima Shemirani, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 74 reviews

I Am 57 Years Old and Have Excess, Loose Skin Under my Eyes?

Eyelid scars are close to invisable once healed. Other options might be skin peels or laser resurfacing, each have their own indications and the option that is best would be determined only by an examination.

Ronald V. DeMars, MD
Portland Plastic Surgeon
5.0 out of 5 stars 27 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.